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08/12/04 THU 14:44 FAX 517 3.10 5092 CLARK HILL Z004 <br /> 08/11/2004 13:02 602728NWw4 BRAES PAGE 04 <br /> California Nater Service Company <br /> 1550 W_ Fremont St. Suite 100 <br /> Stockton, CA 95203 <br /> INFORMATION REQUIRED TO <br /> REFQTJEST AGREENENT <br /> Date; /e/0-a- Project# STk 060 2 6 <br /> 1. Name(s) and address(s) of the parties with whom/ agreement is to be made: <br /> 2. Description of contratc,ting parties (corp., partnership, etc.)- <br /> Cor V 'cam- -Q" <br /> 3- Name and address of party designated to receive refunds (if applicable) <br /> 4. Subdivision, track or property to be served: <br /> Z6 3q K. w;lso., way 54Gk4» 95`2-S-0 <br /> 5. Easement required? If yes, provide legal description or Recorded Subdivision <br /> Map (approximate date to be recorded__ 11o=1 e. (V;,•,re A <br /> 6. Installing contractor(if other than California Water Service Company)- <br /> Name: Nl4 <br /> Address <br /> Contractor's license#, classification& expiration date h <br /> Contacts; <br /> Regina Coe <br /> Office #209-466-8971 <br /> Fax# 209-466-6155 <br /> 08/11/04 WED 15:53 [TX/RX No 66541 14004 <br />