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Feb 15 01 09: 23a Valtjftd Customer 209 a68-9324 p. 1 <br /> APPLICATION FOR WCROACM4NT pgRMIT <br /> gL�gE PRII`i'i <br /> 3 <br /> Date of OFYXCE usa ONLY <br /> JOB # REF $ <br /> To: San Joaquin County APN CR # <br /> Department of public works EXP. DATE <br /> > _ TO DRIVs1ttAYQ <br /> `�� C VALID ; <br /> (Applicant Name) SSTTRzET QUAD -- <br /> � -- // AREA �l + <br /> 65 <br /> -74 7- .�/L!'Y�c GT TYPE <br /> (Kailing Address) FORMS <br /> • NOTE <br /> (City, State. Zip code) <br /> --------------------- <br /> �zs- s�- sss <br /> (Area Code - Telephone Number) <br /> Sketch (Detailed plans may be submitted) / J <br /> LG<-a�1'aHs a <br /> The underyigncd hereby appii..w for permission to excavate, construct and/ de of <br /> fee mile <br /> Otherwise enc roach on County Highway Right-of-Way on the oimate1 k �(� / <br /> approxGti"G <br /> rn «� the <br /> by performin <br /> of r So,1 +^ ✓� <br /> following work ( scription of work) : 3 � <br /> Am— <br /> for approximately <br /> Work will commence on or 2030111- _� 1,41z! <br /> O <br /> a� p� <br /> L. days. <br /> r am <br /> I, the undessigned certify tot I am the owner of the respective pr servo in <br /> qualified to represent the owner and agree to do the <br /> work accordance with the rules, regulation of San Joaquin County and subject to <br /> inspection and approval. <br /> ...........';9� Date <br /> Signature of App cant - Title <br /> n�sncK.v.�r�ecomL t�/�e/sot <br /> FEB 15 101 9 : 17 209 468 9324 PAGE.001 <br />