Laserfiche WebLink
,, <br />PLEASE PRIM]": <br />Date 6'<~..7 -20 It <br />To:San Joaquin County <br />.Department of Public Works <br />P&~E PIM 31062'1 (7 <br />IAlll"iicalil n~1Jjllel <br />l-lo 1.10 We.s.+L ,u\€.., <br />lMailil1!)AdilHre,s) <br />~I't,k -+{;j "'-CI'\t?j Y20 i{'(Cily,Slt'lJ,Zip ColJle) <br />b2{j~):S ?3._ef¥-3?:..f'xcb.€fr.;e:.ca' <br />~lAma COile ..IIeilJlll10lls l\foo1ber) <br />I Sketch (Detailed plans may be submitted) <br />JOB II <br />APN <br />EXP.DATE <br />VALID. <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />73«J9..-Co REF II <br />CRII <br />DRIVEWAYS: <br />.The undersigned hereby applies for permis,?ion to excavat ,c nstruct and/or otherwise encroachpn County Highca Right-of-Way on <br />the VJ -t G side of 5 e 11'\tvl'.approximately 1675'N .(;?>r;sf e ile IV /£ <br />of ..,.,by performing the follo~ifing work f escription of work):, <br />~e",L:J",eo Detel'ib Nth/V C-r-c>%4'-*'.Flf .'s-tet'"?u./2671:/Nlak:ke i~~~;,Jj,t.!vp "t)C,{I!\~41 6"<;>:"5""W /-Ce II,#---. <br />':2-L"'a-/lP"I-fl;:.&1/\.. <br />Work will commence on or aboilt 7-ir.-:?-o I for approximately Z.days. <br />.(E'i'J.D It -~(J --2,6 It'' <br />I,the undersigned,certify that I am the owner olthe respective properly,or am qualified to represent the owner and agree to do the <br />work described above in accordance wilh the rules and regulations of San Joaquin County and subjectto inspection and approval. <br />fk1klkt Dp~ <br />Sigroruture of Applic~lli •Title <br />!.t\CENrRALSF.RVlao:'IClERlCAl.\1'Us.sV.wK~~_~STEH-PS\El1GROACHMENT PERMrTAPPLICAllOlHlOG (lJ9/13) <br />,{,-,-;;:<.7-~tJ 1-6' <br />[late