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,'.!..': <br />~;/,!,~J\e);~"(}'ij;;,::<~lC\_:~.;T Y <br />"r-.,.~.."'L.',!.~Ie 'L'('I"",0 ,;;n~S.J \_(\.\.1:,'-'~r <br />OFFICE USE ONLY <br />To:San Joaquin County <br />-Department of Public Works <br />fer i £.P"".?>.ll Ii5S"'r:;Z <br />ll-\p[illicajit n~ame) <br />LfoLto tV-e-$"t Lapre. <br />(MiJiiil1!)Alilimss) <br />~ta (:k -f:t'dl ,6ft-15>.....;<0 if <br />(Cily,Sli>le;Zip COlle) <br />(2011 's75,-it./-5 Z <br />iAma Colie •Ieiellllllllie rJI!I!I~er) <br />Sketch (Detailed plans may be submitied) <br />JOB if UiJt5)-& <br />APN <br />EXP.DATE <br />VALID, <br />STREET <br />,'.REA <br />TYPE <br />FORMS <br />NOTES <br />REF# <br />CR# <br />DRIVEWAYS: <br />-The undersigned hereby applies for permission to excavate,construct and/or oth~lwise encroach o~County High~~Right-of.Way on <br />[he U)side of d-e-wt'++.Rd 'approximately 1360 ~lle,.5 _.~ <br />of Jlt F,'(\e-{?d ,E'e.Tt:?r~',by performing the foilowing work (description of work):, <br />Work will commence on or about '7 -/5 -2.b t 6'-for approximately 7-.days. <br />EpJ'D il-20-2bt-l ',. <br />I,the undersigned,certiPj that I am the owner oHhe 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 subjectto inspection and approval. <br />&~DCA,,:"Signa!!lre of Applkant.Tille <br />~t\CeffRALSERVlC€S\CLEruCAl\PUB-SV.\'IK\\,\,\ST8U'SlSjCROACfj~EllTPERN,rr ,\PPlICATIOIUIOG (II9/i3) <br />6 -2.7-;;<6{6' <br />Dale <br />"