Laserfiche WebLink
Date:...COUNTY OF SAN JOAQUIN <br />DEPARTMENT OF PULIC WORKS <br />DRIVEWAYSAND PAVED fRONTAGE~. <br />PERMIT APPLICATION <br />ZUBft&J • <br />Received By:--"-,M~'f)=t-_ <br />CR#:tJ57;aJ <br />CONTRACl'OR <br />Name:tP41AJ?-f <J/Li:J~r <br />~ddress://0:;"'7 ArJ.4J1U4L L-4AJc <br />),State,Zip Code:'-',i-TV ,.)..C>4,S {,<;r :3 <br />\rea Code -Telephone Number:Vb-Cf''i'?-ff'l' <br />.OFFICE USE ONLY <br />.JOB#:11005 ISSUE DATE:APN (1'J'z,?;,()-6"B 'FEE DUE: <br />EXP.DATE:DRIVEWAYS:STREET:fljd ,6tJe:.R.i::>.•AREA:• <br />TYPE:.7:a4M1h..QUAD Aft • <br />fORMS:S~/WI')1P-/7NOTES:(, <br />DRIVEWAY. <br />TYPE:QUANtiTY I WIDTHSAGRICULTURE:I @FRONTAGECOMMERCIAL: <br />INDUSTRIAL:I @RJWRESIDENCE:I <br />.PAVED FRONTAGE <br />lENGTH:Ft.X WIDTH:Ft. <br />T~e undersigned hereby applies for permission to excavate,construct and/or otherwise encroach on County=Rightof-Way on the <br />;)¥Si side of [JIlek--nJlM,12P.approximately ~.r!'U>mt01a;;U/~!?Po ,IJCA'II1PQ ,byinstalling ':J>l2JoI~WlllvAl'//!QA4f <br />commence on or about for approximately days.--------------------'-_Workwill <br />SKETCH (Separate sheet may be submitted)..---'" <br />t...,;sproject be self-installed?~YES __~NO Conlractor's License _ <br />:\CE~ERVICES\CLERICAL\PUB_SV.WK\MASTER.PS\ENCR.OACHMENT PERMITDRIVEWAY.DOC (09/13)Page 1of2