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a;za G�uWe. <br /> r APPLICATION FOR ENCROACHMENT PERMIT ' <br /> Date 19� <br /> f <br /> ,y 87 D ( A9 : 32 <br /> To the San Joaquin County <br /> ,Highway Department <br /> 17. <br /> 'Gentlemen. <br /> The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on <br /> County Highway right of way by performing the following work: <br />' s'Tcc, F� ,ner<rf ,� -I �, <br /> - (Applicant wiil,describe here fully what he wishes to do using reverse side if necessary) <br /> 13JA Al <br /> 1 t <br /> y „'. Submit detailed plans if available. <br /> Space for sketch <br />'34 I <br /> AT <br /> On County Highway <br /> (Applicant.,will state here accurately the location of the work he desires to do) <br /> and agrees to do the work in accordance with your rules regulations d subject to your inspection <br /> and approval. �^ <br /> 4 Signature of t <br /> tPhone Number <br /> ' �yf{�itlQc.,r9 SER cEC�J�O{� .. <br /> Post Ofrice AddressA <br /> Pertnit issued:. ` <br />' PW.24 (9/841 <br />