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To:San Joaquin County <br />.Department of Public Works <br />>4nk'f(}f\.air q,5:20f <br />(Gily,stti@,liiOl Coole) <br />OFFiCE USE ONLY <br />JOB#13"ft5J.-f&,REF# <br />APN CR# <br />EXP.DATE '7/J5«lP <br />VALID 3(7V&0 3I.!i.be-.DRIVEWAYS: <br />STREET 2vil/A la",tI Ell , <br />AREA "J1.fel?!z:'CA QUAD %,~ <br />TYPE FJle Replo=med <br />FORMS So/N~.JNOTES <br />~'~ <br />Pf11 ~1/L./7t;,-eJ <br />~t,t~~~U:);~):,Li~~~fl'W3D <br />PLEASE I"Rll\!l; <br />Date 2.-25 -16 <br />,,.... <br />Sketch (Detailed plans may be submitied) <br />tee $ke..+~~ <br />The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highwa Right-of-Way on <br />the tV side of oS••u,;b 14 t'l-cl ,Q~approximately 0 etJ ile E:. <br />of 1\111"',I-g I ~d ,MM -tet!4{,by performing the followIng work escrtption of work): <br />_______R._e~'PI a e-e.-f>.;1e 75 H5"Sou.'"t'"1"l.."J <br />MA ",+e ('a <br />Work will commence on or about~k~''1.>--~:>..a",...~1~6~for approximately 1::2.0 .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 regulations of San Joaquin County and subjectlo inspection and approval. <br />__R~Daw04> <br />Signature of Applicant.Title "1!--::2.3 -.2.a>16 <br />Dale