Laserfiche WebLink
APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 2/11/2016 <br />To:San Joaquin County <br />Department of Public Works <br />PG&E <br />(Applicant Name) <br />4040WESTLN <br />(Mailing Address) <br />STOCKTON,CA 95204 <br />(City,State,Zip Code) <br />408-316-1767 <br />(Area Code -Telephone Number) <br />Sketch (Detailed plans may be submitted) <br />OFFICE USE ONLY <br />JOB#Z~t2(}5"2.REF# <br />APN CR# <br />EXP.DATE f -15-/6 <br />VALID 2-17-11.TO 4--/5-/6 DRIVEWAYS: <br />STREET £lo>lrrc 5+• <br />AREA 5i()Cktm QUAD cf • <br />TYPE 8ef/Aoie • <br />FORMS $5 !Vhf I<2"t rc"«'h ~ef(lGI•NOTES <br />SEE ATTACHED SKETCH <br />The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County Highway Right-of-Way on <br />the Fast side of Flower St approximately 850ft feet/mile North <br />of F Main St Star.ktan ,by performing the following work (description of work): <br />Digging up 4'x4'of asphalt for a service replacement to 808 Flower St <br />Work will commence on or about 2_/_2_2_/2_U_l_b for approximately <br />PM 31217094 <br />60 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 />Signature of Applicant -Title Date