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m 12+'06/2000 04:07 2093671163 FOOTHILL ENGINEERING PAGE 02 <br /> 5- -N I I rK trf KV-1 <br /> STATE OF CALIFORNIA•DEPAATMENT`-"P-'rSPORTATION [ ( ''r pst"1 <br /> STANDARD ENCROACHMENT.__IRMIT APPLICATION. T �� <br /> FART A <br /> TWO100 (REV.&E7) Tv,.:Y y, ai• <br /> Permmi on is mqueewd to encroach on!Ire Stage.Highway Right of PERhRT tq. <br /> Way aas Follows: (C',ompirtr,dt ihmr:NA Vt1vt appifratbis l <br /> Application is not complete until all requtwd attachments are indudM- � � <br /> 1.00L947Y 2-ROUTE 3&, MILE SIMPLEX STAMP <br /> ��L acp—vg 14 ! ----- -- A <br /> M,ADORES$OR STREET NAME S CrTv _ <br /> III"C (D"ncw and dI►6ranrr lW-m w o) 7.PQRTION QF FOG"T OF WAY <br /> JAA <br /> a. RK BOW <br /> E PMORUED BY ti EST. {DATE 10. N DATE OF S110PLEX STAMP <br /> 04QWN r{3RCl S ❑CONr vcm I DATE <br /> t <br /> 1_MA9C 17EPT71 L AVG.Dt3'1H31.AVG. TH 1M.LENOTH Is.Sumfy4E TYPE I& ESr.COSY IN STATE AM <br /> 17.TYP 1a.DIAAW ER 1!. 1 PSIO P UCT <br /> PIPES <br /> on <br /> 21.FULLY DDESCROE WORK WrMN STATE WW("Iditlonal spame On revere side If needed): Aftch canplete Plans(ntirWnUm 5 <br /> sets Ided 21,8 cafvlmmnT X 284-,~art r $,S'X 11"))SOOM,CW-S,n-Mpa:,OW If aPP - <br /> 1 1 L�t_ z C,`- C C f C �1 C K f i,t. tAil 12C( <br /> �- �. N l 1 1�►�-Fi l�.-� ��..f� �C.3 I ll.-T� �'��- � � � Air <br /> YOUR OWN REfERENCE NO. Hag sm athar C&Wns DePartrnenr fftift ll VOW~ YES NO <br /> {tt"YES,'t„is11y dssCflas Nr � ane elle <br /> n is arty Work being chew an aplplltaerrt s property? S © alrad Tjraein9 piens} S , i.l <br /> 23•is a city,county,or othdw agency Involved in the environmental approval? ~ <br /> YES (Choat dmw&,OrNaitarl*%m and artxh approved copy) 0 CATEGOMCALL.Y EXEMPT N,O, Q EIR <br /> �`IVO jCfliGk fhb CpiOyarybalb�v iY7 aI/Vtfi0Nr73+.,wtlittl OB.9Clt�d4 Ila proj9Cl1 _ <br /> 220- Q Fl-AQ&SWMM MANNERS. C0ra6T mic-1ON f M KATION CW ❑CONSTRIJCYCH.REWNUFFILC IKK MAINTe+IAMCA.op <br /> oeu0 1A?IONS.PMRADE5^NO �J SICX""OR ANY CTHW r%AFRIC CDNTPC�, mpsuRFl cmn OF A LrWMAY CM ROAD AP"XWH <br /> CELEBnATKM Sy5TEJdS AND DEMW.mCL.UOIMO Ammom OR(VJV-#r.£NENT OF RQADWAY DE111DES OR <br /> G�DrVC.4 PAVING AODTTIUM CC-NEW ELEJAENTS- awsaNW(acAnE SCREEN,BAW9110,tjONTIMM STFWMNG. <br /> FJ PUBLIC UTLU"NPDIFICATIONt. MAFOWIM*Tr-) <br /> F9�E <br /> Q MMLI X E7fTEN'f►)rlfw Iuk]IfUp$ [J tcR0fA0N[SMWrF%DL <br /> SIDEWALKS r G urm-Aa <br /> REPAIR!LsmN ENANCE OF Emg"t<!A604WAYS <br /> NONE OF IIP-ABOVE/Ntva m c~0-do—lmd M*bow twat MOLOR AupdmIm p"r a'born"A"arnp OTik1 - ---- <br /> 7i b. 00"it"project pause a sunesme"efw 9s in tree silWffranc*ro a Minors al mw floe? VES .Mfy {It'YES,"request apo inion Pert'a'tram <br /> the PO W olf4!) <br /> 93 c. is this prolpct an an 4WOU lg noiwdy or ENget VA%re the ac*"V It1VobRY removal W a sperm resource Nt kKkV a Savo of trees"a rCx*ouloroPpnp or <br /> a NStorl¢twlktirw Q YES to'YES,"/era MA APPOMOM Part'W/rpm ft Permit 00M) <br /> 77te andwWWned ag nimit and undorAtINKIX#hat s►ala►ntllt Can ba deeded or a baortd raglUfrrd*W 00117-PRIW IM1t Of FWP" <br /> ar pn went ponWt lbsa.that ttw wortt Wit Fut darts In a tmordame wid)CaMmns rvioo Amd MufrlrDforta subs to <br /> fngpsatfott and apOprotraf,and Met permft Mese"W SNI bar dlw whin A"OPPHCOMn 10 weFtridrrwn or dlln►sd,and dW <br /> a d ffho relay be Apaomood in gIevordence IW&Call/orm►s Sbw t and Hfghwsys Cade, &WIf "all-SS - <br /> 2C ORGAM DON OA A C NT NAME(p"or =,2 <br /> C7 <br /> M -A}R-C�HITE�CyT-,,E40I1JEEP QCT MANAGER NA M"m Of Tjrpa) 127.a I <br /> — <br /> is.BUSINESS AOCMES$ C4y and ZO Qm*J �V Sf • ' �� � <br /> �. 2ID 81G Tt1RE W PRINT ORNAME , I 81.TME n DATE <br /> } - E <br />