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APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />AT&T Job#AOOB8M8 <br />OFFICE USE ONLY <br />JOB#7~(JQ79 REF # <br />APN CR#EXP.DATE f.-/£-16 <br />VALID ~~~r~TO 4-{f -(b DRIVEWAYS:•STREET I PI'-AI/•AREA fi"mchfQ!tIf>QUAD fFTYPEr~• <br />FORMS 1f rIi7 1R2CfNOTES <br />'n <br />02/17/2016 <br />San Joaquin County <br />Department01 PublicWorks <br />Date <br />To: <br />5555 E.Olive Ave <br />(Mailing Address) <br />Fresno,CA 93727 <br />(City,Stale,Zip Code) <br />(559)454-4900 g26977@att.co <br />(Area Code.Telephone Number) <br />Sketch (Detailed plans may be submitted) <br />AT&T /Sherry Parks (Permits Desk) <br />(Applicant Name) <br />AOO B 8 M?5' <br />Please see the attached drawings. <br />The undersignedhereby appliesfor permissionto excavate,constructand/orotherwiseencroachon County Highway Right-ol-Wayon <br />the S sideol McKinley Ave.approximately 1200'feet/mile feet <br />of_2nd St.--_-,by performingthe lollowingwork (description of work): <br />Traffic control plan is in place for pole access.Please see the attached <br />drawinqs.Pole access will be on S McKinley Ave with cross streets of <br />2nd St and Old Sperry Rd.Verified county district with Tim.------- <br />Work will commence on or about_0 3 /1 7 /2016 for approximately 03/31/2016 days. <br />I,the undersigned,certifythat J am the owner of the respectiveproperty,or am qualifiedto representthe owner and agree to do the <br />work described above in accordancewith the rulesand regulationsof San JoaquinCountyand subject to inspection and approval.n t:=nOjln e...e..r'"ln 'j <br />~A--i U~-AOYY\IY'ltstn:'tror C).-Ig-(9..0/('0 <br />~pplicant-Title .Dale <br />M:lCENTRAlSERVlCESlClERICALlPUB-SV.WKlMASTERPSlENCROACHMENT PERMIT APPLICATION.DOC (n9Jt3)