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" <br />APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 2/4/2016 <br />To:San Joaqnin Connty-Highway Deparlment <br />PACIFIC GAS &ELECTRIC CO. <br />(Applicant Name) <br />1524 N.CARPENTER RD. <br />(i'v!ailingAddress) <br />MODESTO,CA 95351 <br />(City,State"Zip Code) <br />(c;r2-s23-16 -OOI(p <br />(Area/Code -Telephone Nnmber) <br />TYPE <br />NOTE <br />OFFICE USE bNLY <br />7;005)..REF # <br />CRV# <br />DRIVEWAYS: <br />I <br />Sketch (Detailed plans may be submitted) <br />SEE ATTACHED SKETCH <br />PM,31205481 <br />NOTIF.111071918 <br />days.30 <br />The nndersigned hereby applies tOl'permission to excavate,construct aild/orothetwise ellcroach on <br />COll!1tyHighway RighL'of-Way on the NORTH side of VINE AVE approximately <br />808'teet/mile WESTof S.HARROLD AVE,~~~~~~,by performing thc following <br />wOl"k:(description ofwork)EXCAVATE (1)4x4 BELL HOLE IN RIGH OF WAY AND REPLACE <br />SERVICE EXCAVATION WILL BE IN PAVED AREA.PERMANENTPAVEMENT <br />TO FOLLOW. <br />Work will conllnence OIl oj.abou't <br />J the nndersigned certi!).thaI 1 am the owner of Lherespective properly,or am qualified to represent the <br />owner agree 10 do the work d~scrib~d abov.e in flC-COI'd~llce with the rules,regulatio.lls of San Joaquin ~ <br />Co ,,,I subjcet (0 inspedion and approval.