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E } <br /> I <br /> Date: OIAEoldrV 12 mo <br /> Michael M. Niblock, Director <br /> Community Development Department <br /> 425 N. El Dorado Street <br /> Stockton, CA 95202 <br /> REVOCABLE PERMIT APPLICATION FOR GROUNDWATER MONITORING WELLS; <br /> I/we do hereby request that this letter serve as an application for a Revocable Permit for the <br /> following: <br /> Use and maintain I Groundwater Monitoring Well(s) in the City's right-of-way-at <br /> the address listed below and as shown on the attached drawing: <br /> '730 Fas r CAz%nnd .5-rre er <br /> The undersigned has received a copy of and fully understands the Standard Conditions <br /> governing the issuance of a Revocable Permit for a Groundwater Monitoring Well(s). <br /> (Applicant S' Wroperty <br /> ) <br /> Business owneowner <br /> (Please specify) <br /> &-Ve-r .l y <br /> (Print Name) <br /> -- R1t y rnorid In%lei T'm--,n 60r . <br /> (Company Name) <br /> a17 S. Center SrrSr.&k anew <br /> (Address) <br /> �Z�g� k66��6oy <br /> (Phone number) <br /> G:\CDD1pdv\_Staff_\�BUSINESS OPERATIONS\REFERENCE\EN3 NEERiNGIBrochure and FormslRevocable Permit Groundwater <br /> Monitoring Wells.doc <br />