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r <br /> ON FOR E[1CROACHMEt1T PER <br /> 7 <br /> PLEASE RINT' OFFICE USE ONLY <br /> Date' 66 <br /> JOB.# ��p� CR# <br /> To: San Joaquin County APIC <br /> Department of Public Works Exp.DATE DRIVEWAYS: <br /> VALID <br /> d £.p `ys ifOl eATIF' A J 1+�� STREET , <br /> (Applicant Name) AREA —T QUAD <br /> TYPE <br /> tletofl Oy <br /> S A f+erAB <br /> A <br /> 19 37 <br /> (Mailing Address) FORMS u! <br /> NOTES <br /> 7c�c. T <br /> CA <br /> 95 Z <br /> (City ate,Zip Code) <br /> zAq - � � <br /> (Area Code-Telephone Number) <br /> Sketch(Detailed plans maybe submitted) <br /> T F, Ph ^� <br /> 50�0 fee ile se-4 f <br /> The de *1 edit ereby applies S EA R S10 54a E E ate,construct and/or oth mately ncroach on County High a R' ht of-Way on <br /> the,LA�� side of f e+PEt by performing the following work( escription of work): <br /> v . ,1. A J ty,Ae1Q <br /> °f MW 'A MN'sa <br /> VO W <br /> f'J IA 13-L. I St► ,�/LC <br /> n Co ' A <br /> days: <br /> r approximately <br /> Work.will commence on or about s p ¢Z b f <br /> fo <br /> -es <br /> I,the undersigned,certify that am the owner of the espective property,or am qualified to rep ?ntthe owner and agree to do the <br /> work described above in accord <br /> with the rules and regulations of San Joaquin County and subject to inspection and approval. <br /> PA <br /> pA Date <br /> MAku.re of Applicant-Title <br /> E:NUBS1WRMk5>EA <br /> HFNT ppRM�iMFlIu"ON OJc po, - <br />