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.<;.tp I,jG{c>.'1 ,~fir q~2.,0 if <br />(Cily,Siat0(ZilJl r01H~). <br />[2 oq;J ~7'S~f t.f :5 <-.(Are@ Code"I efe!Jt1olie 1\!!Dm!Jer) <br />To:San Joaquin Counw <br />.Department of Public Works <br />t/{/'ilt?tVe,S-f L.<~Vle: <br />~\R~~ingtlf.Mress~ <br />OFFICE USE ONLY <br />JOB#22()6 D;}.-G<>REF# <br />APN CR# <br />EXP.DATE _~_J(~•_. <br />DRIVEWAYS;\f~I;~r~Z/jJ11l,_.'L~41J!io .SIR,,~.!_.'{p_A•.~.___~___..__.. <br />-~ARfJ\?Jl~~:l~:£~------,., <br />TYPE.'"_._--------- <br />FORMS ¥~Je2NOTES <br />SimIch (Detailed plans may be submilied) <br />.The undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on CounlyHighway Right-of-Way on <br />the Ni£side of.N Oro Ate ....app(Oximateiy z'g(r f@lmile~;J~~ <br />of h::rWi G+,Sfext'..fow ,by performing the following work (description of work):, <br />Work will commence on orapDlit 7--16;-26~6..for approximately ':L days. <br />.ErJO 11-20 -26t£....'I,the lindersigned,certHy that I am the owner oHhe respective property,or am qualifledto represeJitlhe owner and agree to do the <br />work descrjb~d above inaocordance with the Mes and regulations of $anJoaquln.Gounly and subject to inspection and approval. <br />G -27-::<0/,{ <br />!l.le