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FROM : Ground Zero Analysis PHONE NO. 209 e3e gee3 Sep. 24 2003 10:21AM P4 <br /> No. Ol Oc O2: -•1P Veld Custom,-t' X09 4C�tPe93-24 F• � <br /> APPLICAT:rox FORNCRjDAC7Dg=- pRn.IL�T ?)�� <br /> PL A3 I+fit IN2': 1�r"73 <br /> Date .2Q 03 .07TICS G33 ONLY <br /> T:; San Joaquin County <br /> Depart rant of public work_. a vN CA• k <br /> � t).�1�Q xlZC1 �Nf}Lti(S!S /�K.. AXP. �x11'E <br /> I�FP�=haat Nnme) sTREE �� _ '7�j w _ <br /> ^1 7, <br /> tblaia:ag kddrass) RO17ASa �� -7q <br /> SLAG Qom,/ C!- g 0 !COTE <br /> (City, State. Zip Cada) <br /> (area Code - Talepltet a X=Jar) <br /> akeLUh (oacasled plana may be sa.:mittad <br /> w c_t_ Co NST. v C r z r).v 46 c r1o�✓ <br /> 'A -I-T--O* c&-'s <br /> x"a Ulldrxaig-,ed hereby applies fox permission to excavate construct and./or <br /> cther�risa encroach or. County H.,F.%. y Right-of-gay on the (�✓Fs_r_. a:Laa of <br /> s ?�.vr.�rrt-i GAN apPccxjm�.e=Y c- /roi1G .ScicrTI+ <br /> �� v 3 LN iJ RL by performing the <br /> work (draacriptien of <br /> Wc.k wl corsnence on or out 3 O £r3« agproxisaately <br /> days. <br /> Z, the undersigned certify that; am t)"e Owner of the resPectiv* property, ar am <br /> Val4fied to represent: the owner and agree to do thr- w=k descrihnd abcve in <br /> accardance with the rules, regulations of San uoaquin Cot,--v and subject to <br /> 1nBpegtior. and approval. <br /> p- 1crr �S 2d <br /> o£ Appliesa:;L - Tule' Dxto <br />