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OFFICE USE ONLY <br />JOB#13DO!d.-(P REF#•APN CR# <br />EXP_DATE~ <br />DRIVEWAYS:VALID ,~TO-4dln <br />STREET Kirk:.A~.,;, <br />AREA Sf6C.k.+./\QUAD CA-, <br />TYPE fh~g,~-al2>.f~• <br />FORMS S?(lA)YJ,; <br />NOTES <br />To:San Joaquin County <br />-Department of Publio Works <br />fG /r=.&t .:;{r;3.7706 <br />(Ailplica!il~~me) <br />f'UEASE PRINT; <br />Datee-~2.o16 <br />t.{(I ~"vJ e-tf:kf\e <br />(Maiiil1gAdiillress) <br />5.t"6Ic--tb 1\,<!.1'r q£"..2 ()t( <br />(CitY,St~le,Zip C1Jo1e) <br />(;?o<:f)3?-'1 fx:d:z€e-,coM <br />(Area Code -ifelelll1llllie iVllJilliJer <br />SI<etch (Detailed plans may be submitted) <br />~ee..-~f.:::e+ek <br />C l'e4).-to C-tt II ',;~c-'a l2 ()q )1;-.3 -71.[:21 4-B iz;. <br />72.t-Lt't.t-\r>be&or-e-wo,.ok.5-td r-f.5,C"r-etO j>f.M..lJ F"eft.<.eSt' <br />_\1~.v'1\cleCu-ttlAce,1I ';--or-a-~wor-k d-u.I'~~({:H~i'€-f' <br />1M.-6t'\-t4.J.Nt.>V'e-IM,bBt'-TkMA 1V\--4.,"~'p <br />-The under~ned hereby applies for pejOlission to exoavate,construot andlor otherwise enoroaoh on County Highway Right-ai-Wayan <br />the 1=side of k,,-f.<::Ave -_approximately 17 e mile_.5~__ <br />of AI.E /"e-A ve,,,-5..--t-tlet.::..+"".,by performing thefollowing work escnption of work):I?.eflga-e'Prit14ar:t Rlc~2<{c::;a k,'rk.;1-ve <br />Workwillcommenoeonorabou!tf/-f3.l -~6~l;for approximately ::2.days. <br />IE rvD 1-IJ.--'7:Wl7 . <br />I,the undersigned,certiJYthat I am the owner of the respeotive property,or am qualified to represent the owner and agree to do the <br />work desoribed above in aocordance with the rules and regulations of $an Joaquin-County and subjeclto inspeotion and approval. <br />~Dd~.Signarure of Applicant.Tille