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35314133- C-1923 - CHEROKEE & LAGORIO <br />SHALLOW BED ANODE INSTALLATION <br />APPLICATION FOR ENCROACHMENT PERMIT <br />PLEASE PRINT: <br />Date 6/1/22 <br />To: San Joaquin County <br />Department of Public Works <br />PG&E - TY CAULK PERMIT FACILITATOR <br />(Applicant Name) <br />3136 BOEING WAY <br />(Mailing Address) <br />STOCKTON , CA 95126 <br />(City, State, Zip Code) <br />(408) 313-0963 <br />(Area Code - Telephone Number) <br />JN23@PGE.COM / STDIVPERMITS@PGE.COM <br />(Email Address) <br />JOB # <br />APN <br />EXP. DATE <br />VALID <br />STREET <br />AREA <br />TYPE <br />FORMS <br />NOTES <br />OFFICE USE ONLY <br />730052 <br />REF # <br />CR # <br />612712022 TO 811512022 DRIVEWAYS: <br />—ehookee-Rd. <br />Stockton QUAD NE <br />ren-ccii <br />SS/WW, R-29, Trench Cut Policy <br />Special Conditions <br />Sketch (Detailed plans may be submitted) <br />*SEE ATTACHED DRAWINGS AND TRAFFIC PLANS FOR WORK DETAILS <br />The undersigned hereby applies for permission to excavate, construct and/or otherwise encroach on County highway right-of-way on <br />the NORTH side of CHEROKEE RD approximately 50 feet/ 0mile EAST <br />of LAGORIO RD by performing the following work (description of work): <br />SHALLOW BED ANODE INSTALLATION <br />*METHOD OF INSTALL WILL BE OPEN TRENCH <br />Work will commence on or after 6/27/22 for approximately 14 days <br />I, the undersigned, certify that I am the owner of the respective property, or am qualified to represent the owner and agree to do the <br />work described above in accordance with the rules and regulations of San Joaquin County and subject to inspection and approval. <br />Ty Caulk oat, 2022,0602Y115621k-0700' 6/2/22 <br />Signature of Applicant - Title <br />Date <br />