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i <br /> APPLfTION FOR ENCROACHMENT i MIT <br /> h <br /> Date: December 3, 1991 <br /> To the San Joaquin County <br /> Highway Department <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 /> Drill 1 to 2 soil borings and install 1 -2 monitoring wells <br /> (Applicant will describe here fully what he wishes to do usinb reverse side if necessary) <br /> Provide traffic warning signals per CalTransuidelines. <br /> 9 � <br /> Drill up to 2 soil borings (8.5—inch diameter) using a truck mounted drill rig. <br /> Upon completion, install an Emco—Wheaton 721 or,similar traffic rated road box. j <br /> Access the well quarterly for monitoring and sampling. <br /> i <br /> Space for sketch Submit detailed plans if available <br /> See Attachment 1 for location <br /> See Attachment 2 for proposed construction <br /> i <br /> On County Highway on easment, east side of Hansen Road, 500 feet north of center line of <br /> West Von Sosten Road <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 and regulations and subject to your inspection <br /> and approval. f� <br /> Signature of Applicant <br /> �•c= � 3;�-> - ;l.==SCC; <br /> Phone Number <br /> Post Office Address <br /> Permit issued: <br /> ADWrJ\F0RMS%EN CPZF M.Vk'K1 <br />