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.;::::CE"EI:.SAN JOt,QUIN COUNTY <br />OFFICE.USE ONLY <br />JOB;\!IIOOIJ>REF # <br />APN CR# <br />EXP.DATE ?-{f -If.. <br />VALID ~-9'-/6 TO -2::J5-fb DRIVEWAYS: <br />STREET 5"aMrr(~, <br />AREA f~QUAD /liE " <br />TYPE , <br />FORMS {r;;,W 1.>.2 q ---- <br />NOTES <br />f~g 102.3 t ~:f7 <br />~~U~q8t~T~~~~!ITft!~J\ <br />.$-t~ck-t~"I\~_c._A _ <br />(toQy,st~e.lilOl iCililllGl) <br />(zoq)~7~-44~::?. <br />(Aroo Coile.lela!jlll111il8i\iIJi11ilew) <br />~lEASE~Rli\IT:JEt'T.Oi'FUGLIe WORKS <br />Date ;z..-;Ztj-.2.bI6 <br />'ioLlo We>,\-,L~\'\e <br />$lQ()j~~UiJ£lP~~,rr;J~ss) <br />To:San Joaquin County <br />.Departmentof Public Works <br />Sketch (Detailed plans may besubmitted) <br />5'e.e.S fceTc.IA. <br />Ttli'>fe'f'iA-tl'r "it;be pavcJ..fOr bg Ap,oI/6:M-t <br />Cf6-jt:CUGi'oMerJ Cot'\i;r-t(e:.-wr)1fJe.t-rec-~~~~ <br />The undersigned hereby applies fo~perrJ)issionto excavate;,construct and/or otherwise encroacti on 90unty Hi9hwaY~i ht-of-WflYonthegOTHsideofG>tfi Nt2!Rt4 ~D approximately Ie 6 feet!lie 5113 <br />of C-A-P-.T L!'E,u'/M /Y1'jTO".by performing the following work (descnp 'on of work): <br />_Gu.~-ttl>lolAe.r :¥~e'\i:n;:l c.:to('=to ba rewuRer-E £"/\()(?1./?dl <br />4.?ner ~ke:te-J1l =to In GT<tII t/'70 t "(?WTt'r Ouc.:t"tI';"=t r4 Mac -r-a e.q~pe-rw...'-t:FeeS. <br />Workwillcommenceonorabout 3-H -26 £6 for approximately 7':<CJ 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 subject to inspection and approval. <br />.e.D~ <br />Signature of Applicant.Tnle