Laserfiche WebLink
P/11 3/Z-'370Zb <br />.,..,..."APPLICATION FOR ENCROACHMENTPERMIT T <br />PLEASE PRINT: <br />Date <br />To:San Joaquin County <br />Department of Public Works <br />PG&E <br />(Applicant Name) <br />4040 WEST LN <br />(Mailing Address) <br />STOCKTON,CA 95204 <br />(City,State,Zip Code) <br />408-316-1767 <br />(Area Code,Telephone Number) <br />JOB # <br />APN <br />EXP.OATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />'13()()I)2'(P REF # <br />CR# <br />Sketch (Detailed plans may be submitted) <br />SEE ATTACHED SKETCH <br />The undersigned hereby applies for permission to excavate,cJ.lnstructand/or otherwise encroach on County ighway Ri.ghl,ofcWay on <br />the II/v..,erH side of 6/tsr /Jt!1I/J1?t)trOlf.p approximately t.feeU~EAST" <br />of AI PES @OIl1lE..f ,l?lJ ,7lMdtPO ,by performing the following work (description of work): <br />3!IJO E.t!I!Il/l1&)t?o"!l1//,4%.e£h,fI't;~t2fog,Btl'!:!~1'11:fz::1TALj&7~/V' <br />SiJ(lm ~/LJc t2.r cA5'T &Am?1J Rt'I'J..L?70 /A/S7;t1t'l 1"(6,4:$t"e'i Y c t/NG <br />Work will commence on or about ,f -I:>-/6 for approximately 0 days. <br />I,the undersigned,certify that I am the owner of the respective properiy,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 />/It!vriL~-6¥6S77w.4me <br />Signature of Applicant,Title <br />E:\PUB.sV.WKIMASTERPSIEMCROACHMENT PERWJTAPPLICATION.DOG (OiI{l8) <br />~/~//0 <br />Date