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PG&E pm# 31087561 DEQ lt . <br />APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 11-19-2014 OFFICE USE ONLY <br />To: San Joaquin County JOB# qZ- REF# <br />Department of Public Works APN CR# <br />EXP.DATE L - 2O/ <br />PG&E VALID TO -l y l DRIVEWAYS: <br />Applicant Name) STREET <br />AREA QUAD v <br />811 W J St TYPE edy-le- <br />Mailing Address) FORMS <br />ys51wtT-!l <br />NOTES <br />OAKDALE, CA 95361 <br />City,State,Zip Code) <br />209-576-6624 <br />Area Code-Telephone Number) <br />Sketch(Detailed plans may be submitted) <br />O HALL RD <br />3-715A 17.2 WI <br />AOIvAM-CD <br />I <br />11 ® <br />REMOVE POLE; <br />INSTALL POLE, &C/N. <br />SPHOLE; <br />INSTALL 15A TX C/N.& <br />TRANSFER SPAN 4UY <br />L22INSTALL 60'4/OA IVC V.tRE <br />TREEE TRIMMINO IN FRANCHISE <br />The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br />the N side of HALL approximately 1450' feet/r E <br />of HENRY ESCALON by performing the following work(description of work): <br />POLE REPLACEMENT, TREE TRIMMING, SERVICE WIRE INSTALLATION <br />Work will commence&ReP@4ed4 between Jan 5 and Jan 9,2014 for approximately 1 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 />00°`IV_-' ESTIMATOR, PG&E 11/19/2014 <br />Signature of Applicant-Title Date <br />M:3CENrRALSERVICEMCLERICALIPUB-SV.WNIMASTER.PSIENCROACHMENT PERMIT APPLICATION.DOC (D9/13)