Laserfiche WebLink
,UIii MAfi2 I Al'i 9:3 1 <br />To:S@nJoaquin County <br />,Department of Pulllie Work!) <br />Ii"llE/.\SlE li'RI!\I1: <br />Date iJ~11~20ij6 OFFIGE USE ONLY ,. <br />JOB#REF II <br />fJJ'N CR# <br />EXP.DATE f'//;«r.. <br />DRIVEWAYS:V~l~_$!Jltr--,I ~O,:J¥ij.JIR _ <br />S IRl:E I 'fJlijr.td ~" <br />AREA ~k-_QUAD -!:!~__,'-'---- <br />TYPE ~l'~fldan1errf " <br />FORMS "tt-.fvtJ <br />NOTES <br />!Pi'J'i ~II6 q 5t>:2. <br />{~~~r,~'~0!~~~l~m~p <br />"',,7'"",,,\~-,,'.A,',,R,'i~e:JiK""',AI\JI.,;;;'\,dlP'(l/"'~'"8"~1 J ~v II""'",p:::IY ! <br />(iGilty,Srn~@,ilili!tilll!1e) <br />(2f?S)~7:;r-qSf32. <br />(#lre@Clilll!1e.IeiSIPI!'uIVll@ mJiJl11lbeli) <br />Sketch (Detailed plans may be submitted) <br />tee a<."'-+f![""heel <br />The unders!@edherebyappliesforp8lmissiontoexcavate,construct and/or otherwise encroach on county,HighWaY~ht-{),f-Way on <br />the ~side of W W""tJ.6•."~e,eel ,approximately Z feetl~to <br />of 1f"'011 F x,.e I Rod ,.L "I):r...by performing the foJ/owing work (description of work):~••.P 14 ,.e-G '>4'1 '$"'d""it /6le <br />Work will commence on or about forapproximatelyG,,«B-l-~b 16 days. <br />J,the undersigned,certily that I am the owner of the respective property,or am qualified to repmsent the owner and agree to do the <br />work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br />J<o~ <br />Signature of Applicant.Title,3":17-::wl6 <br />Date