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FIELD DOCUMENTS FILE 1
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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2103
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3500 - Local Oversight Program
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PR0544591
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FIELD DOCUMENTS FILE 1
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Last modified
6/21/2019 2:26:57 PM
Creation date
6/21/2019 11:30:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
FILE 1
RECORD_ID
PR0544591
PE
3526
FACILITY_ID
FA0005220
FACILITY_NAME
CHEVRON #9-4054
STREET_NUMBER
2103
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12308029
CURRENT_STATUS
02
SITE_LOCATION
2103 COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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r'tA7-14-'nq THU It_, t1 1r <br /> PGl"_ T F i C ENV S,04:� OIJP P 02 <br /> TFt. th-: .- _ :.•_^',f?'� unt;, cra <br /> try;',_�-_. _,.. ..F' 09:_" .-_:�,,,` �. _.-. I t•.• 1. <br /> APPLICATION FOR ENCROACHMENT PERMIT <br /> Cate . 19 <br /> 0 <br /> To the Sun Joaquin 'oliitty <br /> liishwdY Oeparunant <br /> Gan0ement <br /> The under*igned hnrvhy applies for petmiseion to axcavate, construct and/or other to enerot+1h n <br /> County flI way right of w by performing the following work: �k <br /> �trn 0. •So ,{cls rnyes+t�a,4400 alk) kit' Ave, Y un !/tb 6"r <br /> pp scant will describe hsra liy what he wishes to do using rt�+ra_tr e aide if necessary) <br /> vro ctf fhe iw 512LO1 on g_Na tP� <br /> .hr <br /> fie, PIS .. u�r tl laz -I rn nu-, ) (/75!cr�tfd+ 11 <br /> 66 In G�f`t Ike a <br /> `arne�'er � 1 y <br /> r[r1 {�Y-moi r W f f� I Ptil tJ f-f'T l i rt ✓�0�+4f • _o <br /> rll' Coil) <br /> n� m�.�....�. . ' - � <br /> Space for sketchSukmit detailed i e if availsbl <br /> Sr of Und['ti t7 5 Culp <br /> 11611bd e w40 y� � .6 1 . <br /> ground wafer <br /> c��f f-a ch got. -54e, (roc �za T <br /> 0 <br /> On Cawnty Hlghwsy(Applicant will will state here accurately the location of the work he deslres to do) Tv <br /> trod agrees to do the work in accordance with your rules and regulations end subject to your inspection <br /> and approval, <br /> fm41,. �f�eyforl <br /> •.Ignx,�qua of Applfc t <br /> PERMISSION IS HERESY GRANTEC, G, 1 <br /> 4 <br /> MAKE AND UTILIZE A� q <br /> THE ORIGINAL qog. - 8t — G, 5,312 <br /> EXACT PHOTOGRAPWO REPRODUCTIO, h` ne qutn Jr _ <br /> NS OF THIS FORM AND AIIACMMENT• /,/00( CIV IG CPn+er' -Cr. <br /> /I Vol <br /> cuttoe�� <br />
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