Full Text
ALPINE COUNTY APPLICATION FOR ENCROACHMENT PERMIT TO: Alpine County Public Works Dept. DATE: 50 Diamond Valley Road (530) 694-2140 Markleeville, CA 96120 (530) 694-2149 fax Min. Fee: $50.00 1. Application is made for permission to temporarily excavate, construct, and/or otherwise encroach on County Highway right-of-way by performing the following work, or function, on County road(s) (Crossroads or Engineer's Station) (Applicant to describe fully the type of work, or function, and what they wish to do, use reverse side if necessary. Give dimensions of excavation and sizes of pipe and type of surface to be cut, if applicable) ASSESSOR’S PARCEL 2. Attach detailed plans, if available, or a diagram or sketch, and detailed description: Plans attached Not available 3. Estimated starting date: 4. Estimated completion date: 5. Remarks: 6. Applicant agrees to do the work and accept the permit subject to Alpine County Ordinance No. 247 and Public Works requirements, inspection and approval. initial) 7. Contractor’s Name: (If Applicable) License No. Phone Fax Address: 8. Owner’s name: Address (Physical & Mailing) Phone Fax 9. Architect’s name: (If Applicable) Address: Phone Fax By: Title: (Authorized Signature, Owner/Contractor/Architect) G:\220ROAD\31ENCRPERM\encr.permitapplic.wpd