Laserfiche WebLink
," <br />APPLICATfON FOR ENCROACHMENT_P_E_RM_IT~~__--------~ <br />PaCific Gas and'Eledric C.o. <br />4040 W~srLN",. <br />Stockton,CA 95204- <br />----~~.._---_._---------------- <br />PLEASE PRINT:..::::r '7/'ll- <br />Date''JU~1L.-!t?)Lp'..'OFFICEUSEONLY .. <br />."",,,,,11):,,-",,..SanJoIil8~inobQUnty.-.•w_o_.'-"~'-'~'~-'"-."__JOB.ffi-.__.."~'23l-i?--I.2?-2__f?EE_ffi_..-.-.--..----====-=- <br />...-.De))artl]Je_ntofJ)ubJi!;.lN.lJrk~__.m ...-.'-'-~~~~DATE--~-j~:::J;i-=--T~Gf?#_..-~--.-._-~-..-. <br />,VALID 'f'-I-16 TO 0-I-Ie DRIVEWAYS: <br />,STREET J;V""o~y "• <br />,AREA II11i QUAD * <br />TYPE * <br />fORMS <br />..NOTES <br />(406)6U;-17t:o 7 <br />..(Area Code.Telephone -Number). <br />Ske"tch(Detailed plans may be su~mitted) <br />See attached skelch.PM3!2~GoI <br />Notif.\ll6il s I~. <br />I'! <br />", <br />iII. <br />Traffic Control Plan <br />Shallqe as.per <br />current M.U.T.C.D. <br />California supplement. <br />Please return penn it to: <br />CCD Desk <br />4040 West Lane <br />Stockton,CA 95204 . <br />'ruc~d/or otherwise encroach on Gouniy Highway Right.o~on.I;:.~roximate[y !Db .'feet1lll1i~t~:::_ <br />."by perforfj1lngthe following work (description ofwbrk): <br />Work wiIIcommence on or about for approximately days. <br />e igned,certify that I am the owner of the respective property,or am qualified to represent the owner and agree to do the <br />cribed above in acco ce witht uiations of San Joaquin County and subject to inspection and approval...... <br />Please return permit to: <br />CCD Desk \ <br />4040 West Lanestockton,CA 95204 <br />'<Signajure 0 AppJ~nt.Title.JE/...I.t Dt2.iEff/";':"-C s-r <br />E:~UB-SV.WKIMAmR.PsfENCROACHMENTPERMrrAPrLIJ.T1~(olJF-(,