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.. <br />i"lIEASiIE b"'~ml1: <br />Date i}~17~2D~6 <br />To;B@nJoaquin Cdu~iy <br />.iJeprnent of PulbliG\/limits <br />_)",-1'?~1 ,E P.".,3 t l tt1So If <br />q~~~r,IT~;::B~~1:ifIIITF~1! <br />c ,;."".n_"'Aiif,ff.:,~e;:<"'>.~l!J.l;;;;'"'Q,<.OJ~~''''l.,9 ~"If;;P~lW I)itiaJ/,S{0J~e,Zil'l(;(Ili!lle) <br />{:;,~.>.!j7?f-Cff~34 . <br />(P.1J\J0l Colille.lfiilii!!lJ1llillllDlle~gl!mliJe") <br />Sketch (Detailed plans may be submitted) <br />See .'it.:'e~q<t-hu! <br />OFFICE USI:ONLY <br />JOB It 13t>o9-i.o REFit <br />APili CRIt <br />EXP.D~.TE .e/t4lh ~_ <br />WiLiE_.iJt/J/"-TO =E~plo _DRIVEWAYS: <br />STR~ET .'Ill ~_&____.. <br />AREA 5Ioc1d;J?oU[.\1)5r;..,---- <br />T'tF'E 7tle--hOlucemed--'-it -FORMS _~vJ I INOTES <br />I <br />The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on Counly Highway ~ht-of-Way onthefisideof.$kA.'$er-Rd approximately I.:I.fee8 S <br />of It ~fh.•.••.~4 r"l •.••••I'A(J-i''''A ~rf ,{"C,M ,=+.•",by performing the following work (descriptio-n-of-w-or-k)-; <br />..({""plat&-e=:¥lft=L~f6ie L/Oqq k'Uc"'r-AJ <br />Work will Gommence on orabou!3-::l.e-.:}a ItS for approximately End'8-'I.t;-'.)0/6 days.. <br />I,the undersigned,certify that!am the owner of the respective properly,or am qualified to represent the owner and agree to do the <br />work descrIbed above in accordance with the rules and regulations of San Joaquin Gounly end subject to inspection and approval. <br />!<o~Signature of Applicant.Title