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.4 -~-----._-.... <br />To:San Joaquin Gciunty <br />.Department of Public Works <br />Pf:r~E.PM .f';tl0LI 37S"1J.\lllllicamia ll~~mel <br />'1tJlLla W"fJ.-s"tk.~e <br />lI\IIaillilll!IJ MiII~e551 <br />~'tty ck-tbfi,6ft q~:2..c'lICi,y,Stile[ZUIJI C!Jille) <br />(;2&;'1)37 ~-q'i-~2..."lArea iClJiie •1 eieJllOOill!i\!llIilIniJe~) <br />Sketch (Detailed plans may be submitted) <br />Date 2.{P/t OFFICE USE ONLY <br />JOBit 73xJ5a..(p REFit <br />APN GRit <br />EXP.DATE "bb~VALID.7/lell(.p 10 It(I{1~DRIVEWAYS; <br />STREET Bruel/,,-Rd." <br />,~REA Aco..M.NJ.QUAD NE * <br />TYPE fMe pk&-mM+* <br />FORMS $,lww <br />NOTES <br />.The underSigned here~y applies for permission to excavate,can ct and/or oth?JWise encroach on County Highwa'Right-ai-Wayan <br />the _r;;;".side of ....,..approximately L.JJ <br />of G A C "';H";"',fCl Qd A "a v"'PO <br />Re.eWee.'Deter-te>(>'l:i'ed Pr,le 2./.''2.5?5 r8 (-fA:€.tL::t 1&7'/ <br />WoricwiJI commence on or about 7-lfj -2bti(for approximately 2.days. <br />£100 11-:uJ.,-26t£.I,the undersigned,certify that Iam the owner OT the respective property,or am qualified to represent the owner and agree to do the <br />work descrjb~d above in accordance with the rules and regulations of San Joaquin.County and subjectto inspection and approval. <br />Fe?Ii D .~1A.A,...r:SigiJatllre of AppiiG~Ilt.Tille <br />'7 '-5 -;;<()/,{ <br />D@te