Laserfiche WebLink
COUNTY OF SAN JOAQUIN Date: <br />DEPARTMENT OF PULIC WORKS <br />DRIVEWAYS AND PAVED FRONTAGES <br />Received By: <br />PERMIT APPLICATION <br />APPLICANT OFFICE USE ONLY <br />Name: <br />Address: I 66 5 % , e JOB#:11005 ISSUE DATE: <br />City,State,Zip Code: QIQ C` s 5 64 APN 9.03-y 0-t FEE DUE: <br />Area Code -Telephone N tuber: 2-6 c- j- /y. EXP.DATE: DRIVEWAYS: <br />STREET: Alpeti-H Qt pw R1„ <br />SITE INFORMATION: AREA:MAty-ECA QUAD 5gParcelOwner's Name: TYPE:Dw <br />Site Addres .S FORMS: WW „17Ci <br />f- -' <br />Te- <br />ode: b NOTES: <br />Arelephone Number: jq- - zDRIVEWAY. <br />CONTRACTOR TYPE: QUANTITY WIDTHSNamAGRICULTURE: @FRONTAGEAddress: COMMERCIAL: <br />City,State,Zip Code: INDUSTRIAL,- R[WAreaCode -Telephone Number: RESIDENCE: <br />PAVED FRONTAGE <br />LENGTH: Ft. X WIDTH: Ft. <br />The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Hi hway Right-of-Way on the64s.f ' side of V4 I'approximately 14.36 e 50am <br />of-aP.AX4 -y° by installing _ !9>tJ <br />Work willcommenceonoraboutforapproximatelydays. <br />SKETCH(Separate sheet may be submitted) <br />Will this project be self-installed? IES _NO Contractor's License <br />SA-kCEN1RALSERVICESICLERICALTUB-SV.WKIMASTER.PSIENCROACHMENTPERMITDRIVEWAY.DOC (09113) Page Iof2