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"lEASE /fIRIIIIT: <br />OFFiCE USE ONLY <br />JOB#13()O9.-'-REF # <br />APM CR# <br />EXP.DATE "~dlie <br />DRIVEWAYS;VALID.~j IIld'/P <br />STREET rt.c.k =[,,,,,,12d.,"" <br />AREA loch QUAD NE:* <br />TYPE !Pie 12..P ke-me",,+*IFORMS~t!JVW <br />NOTES <br />.2di/67-.5"Date <br />To:San Joaquin County <br />-Department of Public Works <br />PG-~E ~~i~a~ll~m~/../'-I 51- <br />l.f (JLltJ lJ.J~s't ~e <br />lMilHliU1111Address) <br />'!f,1:{;#~of tHfj ,(yrq~:z..oq. <br />(Cilljr,Stille!zn!Jl Colie) <br />(2:G'ltfJ 37.?>-'i ¥-~2:-[,Area elide -Iele!Jll1oile fJl!IInYJer) <br />Sketch (Detailed plans may be submitted) <br />.The under~ned hereby applies for permission to~cavate,construct andlor otherwise encroach on Cou~ty Highway Right-of-Way on <br />the fi;side of N:J ",-e.-k I <s,',-'e RJ approximately 1!£o£"'cfclJmile ~ <br />of E $qNfE-f1t tee!LOb +-,byperformingthefollowingwork(descripuonofwork): <br />Re.el4c.e 'De:ter=tc.(?-«-te.d -P,.,{e !b646 IV :IM>k-Ttu'le.».Ar- <br />, <br />WorkwiJlcommenceonorabouf 7-Ie -2Qt6-.forapproxima!ely 2.days. <br />E rJ '()II -;;u')-2tYl-6 -, <br />I,the undersigned,certny that I am the owner ofthe respective property,or am quallfted 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 />7 -;-':;<01 .{ <br />Dale <br />[ <br />III