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~~~~~~~~~~~~~~~~--jPIf1-:5-/~o/-I#tf!e--- <br />,j <br />--------------APPUCATIONFORENCROACHMENT PERMIT--------..-.---.----~.~----- <br />PLEASE PRINT: <br />To:San Joaquin County <br />Department of Public Works <br />PG&E <br />(Applicant Name) <br />4040 WEST LN <br />(Mailing Address) <br />STOCKTON,CA 95204 <br />(City,State,Zip Code) <br />408.316.1767 <br />OFFICE USE ONLY <br />JOB#7 30tl>2:REF# <br />APN CR# <br />EXP,DATE (Q-2q-fb <br />VALID g-/2-fC TO 10."2.-'(.fb DRIVEWAYS: <br />STREET AC?Jn1~O • <br />AREA ACC1rn/i QUAD /lIE • <br />TYPE Pel/hoi e • <br />FORMS ~'Svv tiV f2.,:L.'1 <br />NOTES <br />. <br />(Area Code.Telephone Number) <br />Sketch (Detailed plans may be submitted) <br />SEE ATTACHED SKETCH <br />The undersigned hereby applies for permission to exca'(ijte,construct and/or otherwise encroach on County Highway Right-of-Way on <br />the /IIIJ/'<Tf/side of C,A/fAII1J!.tJKtJ.approximately 70 feeUrf.Ii:te 4/6c:::r <br />of Ah :l2liS .I:l@IA/£S a.,AtV/)J1PO ,by performing the following work (description of work): <br />3~5"O {;#9t!IJ~/CDE::'MV.3r='!>-!/oLE f)//c:;e oFf:;'IllAIN Atl/Z)ddT tY.A ,f6£Wei:,UtfAf/A-T10Al 772 O/!!OIC 1M AsPJ,IA-Lr . <br />Work will commence on or about 8-/:;--It, <br />/ <br />for approximately days, <br />I,the undersigned,certify that I am the owner of the 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 subject to inspection and approval. <br />IJttbd:~GAs UT/IJ1t1-7lJeSignatureofApplicant.Title <br />E:IPUB-SV.WK1MASTERPSIENCROACHMENT PERMIT APPUCATION.DOC (OtlOS] <br />b -/~-/6 <br />Date