Laserfiche WebLink
PLEASE PR!lIIif: <br />Dale OFFICE USE ONLY <br />To:Sen Joaquin County <br />.Department of Public Works <br />fG 1-F-.p~3 \\q 5".;t '1 5"' <br />IAppli(;ll/it fl\!1!me) <br />till qo wet'l:kne <br />(Mamllll i-IlIdress) <br />;-t"clc-.t~/I\.<!-A q~-.:2.0 tj <br />(Citf,Stale,l!p Code) <br />boQ)373-<1/f 32 rx:d2€fFe,coM <br />(Ama Code -lrelepllolle NIlII1!Jer <br />Sketch (Detailed plans may be submitted) <br />JOB #1,?>oo5d-.-G:>. <br />APN <br />EXP.DATE <br />VALID <br />STREET. <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />REF# <br />CR# <br />DRIVEWAYS; <br />• <br />• <br />.5e-e->ke+-e1J" <br />C {'elV -to 6£t 1/'.;-:s Co (20 q )1~.3-7/-/2 /LiB -jz;l <br />72.Ht>(.u:>be67Jre.-War-ok 5-tdr-r.s,C-r-et(l ~fAA,f/t"'eft.<e.sf> <br />'lRtU'".e-1eA.NtlAce II -f-/)l'"a.-VUi-work k\'.;.,.~1..<'J(~fe.t' <br />;'IlL b'H~~Nt>V'e-I,""-b&--t'"\"hf'il M<t.••~cA p <br />.The undersigned hereby applies for'perm'lssion to excavate,construct and/or otherwise encroach on County Highw Right-of-Way on <br />the tv sideof ;=5eo..l>i!I Be,,~<>""4'~approximateIY .ee ile-t:Y_ <br />of GAo"'"f\~~J ,~o(m;tIj '",by performing the following work escnption of work): <br />R,8fUu:o--e.De:tec'/2b::Cfed hIe BAlto LJ9J97 E>'<!-4J6l1 R••,lidtq <br />Work wiJIcommence on or about g-30.....It for approximately ::>days, <br />lEND 1-30-l7 .'I,the undersigned,certifi{that I am the owner of the respective ptoperty,or am qualified to represent the owner and agree to do the <br />work described above in accordance wHhthe rules and regulations of san Joaquin.County and subjectto inspection and approval. <br />~[)d~'SigtJ@t!lre ofApp!icant.Title