Laserfiche WebLink
PLEASE PRINT: <br />APPLICATION FOR ENCROACHMENT PERMIT <br />".•••i..•~..•.~."'.")....•.Ff.~~'l~~)')'''u''j •••,\,','J ",I .'LCo.1",I!r,<:..1""\1 •"-- <br />Date 3-1/-/0 <br />_,.,,_'_"•"'"II'•.••,~.;'~.',,"OFFICEUSEONL',UCI-l ..,"-I'U;;U,>,.".,0 <br />To:San Joaquin County <br />Department of Public Works <br />PG&E <br />(Applicant Name) <br />4040 WEST LN <br />(Mailing Address). <br />STOCKTON,CA 95204 <br />(City,State,Zip Code) <br />408-316-1767 <br />(Area Code -Telephone Number) <br />JOB #'1J~Qf)~(£,REF #• <br />APN CR# <br />EXP.OATE <br />VALID 8 I It,;, <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />DRIVEWAYS: <br />Sketch (Detailed pians may be submitted) <br />Pm .2.IlZ c:,3 L{I <br />SEE ATTACHED SKETCH <br />The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br />the IJOP..rH side of TV£tJER Rb..approximately 182 L/feet/mile LO£Sr" <br />of iJe.l//C.I£S 120.LLJL:JI ,by performing the fOllowing work (description of work): <br />3 S-.5'0 t....:J.TURNER /2CJ . <br />£)(,CAUrlrtE'¥'"'I'/-IDLE OLE!<me LJ1E DMW IltJiJ Cu/'LJP.c 711e: <br />sal/ICe..P£:R./YJ;QtJt5,U/'~s.rIIALr RePLI'lC£)1/1(£'A/7ZJ roLLDW. <br />Work will commence on or about for approximately 10 days. <br />I,the undersigned,certify that I am the owner of the respective property,or am qualified to represent the owner and agree to do the <br />work described above in accordance with the rules and reguiations of San Joaquin County and subject to inspection and approval. <br />E:\PU8-SV.WK\W.STERPS\ENCROACliMEi'lT.PERMIT APPUCATlON.DOC (01106) <br />UIS /.I.D..E.3~21-/b <br />Date