Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />OFFICE USEONLY <br />JOB#{(OO(),[REF#APN CR#EXP.DATE q..'HGVAUD.~r£TO f=l-'b DRIVEWAYS:STREET •AREA (,~Qb1Q}lC •TYPE (kJ{h.If>•FORMS S.sYvlV"P-'2..1 bratrA fro.INOTES <br />PLEASE PRINT:. <br />Date D\1~6/90ILP__ <br />To:San Joaquin County <br />Department of Public Won(s . <br />~~l~:=---"1 (4"'{AflJiliCafltN~..LftL.? <br />~aa'D~QG" <br />(Mailing Address) <br />-~dd::q)J CAt G.6dDs. <br />(City,Stale,Zip Code) <br />Bcq-4LP6 -;A5 J~'. <br />.(Area Code.ielephoneumber) <br />Sketch (Detailed plans may be submitted) <br />8:3"t6 G~ <br />'1'2 ~4"Gnr::.~~\J.v)~ <br />The u9de <br />the <br />of <br />igned hereby applies for f1l'tTIiis~ion to excavate,const~t and/or otherwise encroach on County Highway Right-of-Way on <br />.'sid of O.x~~"f (11lD2.l-approximateIy.\f:rt)'~i1e_'__ <br />.IV").by perfo ing the followin work (des "p.'n of rk):•11 I \ <br />-I-.-J(a6 C.'j P'4="""'!!Z-"1"\lVil=':I Qce kb.ll \I:ntv:>~~~,'PK~~rd\i-------'--_ <br />Wont will commence on or about for approximately days. <br />I,!he undersigned,certify thall am !he owner of the respective property,or am qualified to represent the owner and agree to do !he. <br />work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval....Q~01 /!J5 )JDILjL . <br />ilIe I Dale