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,\ <br />2UlO ~11\R2 I AM 9:3 j <br />i'LIEIlSE i'Rmnr: <br />Date i3~7 -2e>ib OFFICE USE ONLY <br />To:SanJoaquinCOUl1ty <br />,Department of Pu!Jlic Woriis <br />I"{;-:,E 'i~'o:"3 It "7 0 ~e;€;I~~-"'-'---=,-,~-----------(~~Jifi.~~~t'~~f:1B:l) <br />S b,&k:;,,\»&1'!t:-,,~c;l':r~<;)~ <br />(iCiltjr,Si<Jt@,ili~iCl]rrJlJ; <br />{2~"i.l ,!$7;r-Cft{3:J:.. <br />(i\ao;~IGOJrrJil.1i'ei~IiOJIilGl ~aJJmiJGlfl <br />Sketch (Detailed plans may be submitted) <br />See..a:H"l ehe4 <br />DRIVEWAYS: <br />The undersigned hereby applies for permission to excavate,can,s!ruct and/or otherwise encroach on County High~Right-of-Way on <br />the .$side of C,.telM e tit approximately /(/0 ~ile W <br />of w t'?f h 1/\(,ld\,.5i-fJt!1c+6"-,by performing the following work (description of work): <br />,"'pi?,!te.-e::""I'ft=t~fb1e r"'.a.r or 3&1 /::L ~leVVl-erd I ~t:f!<'k:+tl(A <br />IV ,de e",'<'dell+"'!~-tree:t -1$~'i."-t,...q <,+,'t la'll?-f-Q I"e M<l!/ltj <br />e>fe..e~ALL "'t ,'•••~$.M.of'"(".IE II-eM,'<'le C <br />Work will commence on or about for approximately {:;•••c1 8 -I-~Oll(days, <br />I,the undersigned,certify that I 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 Counly and subject to inspection and approval. <br />;<00.-:.. <br />Signature of Applicant.Title 3-7-~oI6 <br />Date