Laserfiche WebLink
ll'lIEASIE 1P'~ll1fIf: <br />Date p ~7 -2c>~6 Or-FICE USE ONLY" <br />,',"".. <br />To;San Joaquin COUll!)' <br />,Department of Public WOIitS <br />?b~/;;R-rJ',~lIel1D37 <br />(ff~~~nfiGft\~u'~\~fJm.3p <br />5 'l'gd~.•\~011!,t:-{:\e;f~~l:>tj~ <br />ItillJr,S/.tll!,ili~C!li1l\'J) <br />{2~.>:n'ij-9if32. <br />(O\roo QlIIII~-1rllill1~lJi)i1lllmtlU!riIiJ~n') <br />Sketch (Detailed plans may be submitted) <br />tee.a:I:+~ehd <br />JOB It 1&A5j-(p <br />API\! <br />EXP.DATE <br />VAU!D <br />STREET <br />AREA <br />TYPE <br />FORrviS <br />NOTISS <br />REFt! <br />CR# <br />DRIVEWAYS: <br />.;--~,',--'- <br />The undersigned hereby applies for,pefJJ1ission to excavate,construct and/or otherwise encroach on County Highll(<r{Right-{}f-W<lY on <br />the W side of {t lOVe rc.\e....approximately II£:@.lle __S__ <br />of $t e t:It'iii 'IV DO P 8r,'d1@..-bYperfofJJ1ing the following work (description of work): <br />,({"-plate.==\(1£+1\\3-o,le '?,({t.el R,'o UQ-td~e_,_ <br />t ;-tt(l~I»ill Pa.1'-1-::""iV.~,'d-e o.f R,o uetdlO: <br />oren IOlle I:;"!A.,tII be &a,'/A'i'4,'(Il"d A+g/(-t,'Mes 1£".s,:~. <br />"WorkwiilGommenceonorabouf 3-2 .•--~"!6'forapproximalely .-~"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 subjeclto inspection and approval., <br />j(..o~ <br />Signature of Applicant.Title 3-,7-20/0 <br />Date