Laserfiche WebLink
PLEASEe"m~~lf: <br />Date :J~2-2c>ij6 <br />To;S@nJoaquin COllnty <br />-Dep@rtmel1tof Public Works <br />')/"_,1£--0__~v ~(~Ii 11"\3 117 Lfl-5"~/_-Qt%~.;P~C.i:f!~~~~;{)lITB]" <br />l::u;'4,.)!!f7 ?£-q Il;/.$2.. <br />(Are~iClliJ~.If!lle~lfulll1~@jlnrn!lle,l <br />Sketch (Detailed plans may be submitted) <br />;<?Je.@t:t+'i/e.hed <br />OFFICE USE ONLY <br />JOB II '13tXJ5J.~REI'II <br />APIII GRit <br />EXP.DATE __~I<hr" <br />VALID -i./J£/J"TO -fiiWIe DRIVEWAYS: <br />STREET ~i!.~Rd., <br />AREA ~Jf;p QUAD NWTYPE~=itJ,ce4YIRd fk1iff6(fU{ <br />FORMS $ivJuJ <br />NOTES <br />days, <br />The undersigned hereby applies for permission to excavate,con truct and/or otherwise encroach on County Highway Right-of-Way on <br />the N side of 'approximately t>,5:.fee~W <br />of eA?t~t ',AC-dlt!.l,fO'by performing the following work {descfip1i'onof work): <br />___-~R~e~p~l=tl\c~-e.~~'f-etJl5.f=",:MeC ft It::<<q "0 IN lUodb,.,'¥fbi <br />______~A~,,=+-t:-t-<I/:L__I uJo eft;t2"'(~< <br />Work will commence on or about 3 -~-~,~2,~b~l~b~f,or approximately <br />J,the undersigned,certify that I am the owner olthe respective property,or am qualified 10repmsentlhe owner and agree to do the <br />work described above in accordance with the rules and regulations of San Joaquin County and subjectlo inspecUonand approval. <br />i<-o~Signature of Applicant.Title