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PUBLIC WORKS DEPARTMENT No. No- 1 1 F 9 <br /> 259 N. Wilma Avenue <br /> Ripon, California 95366 <br /> 209-599-2108 <br /> ENCROACHMENT PERMIT <br /> TO: Name I luorDav�%e'k fGTS 4rrQeSt1C Date issued <br /> r ' ito - 29 -9-7 <br /> Address 757 ArnollqD�riycr Sfe. L> Contractor WCj5 ggZM Lt JR�t�� (o( P, <br /> 1'IArI,VleZ , CA 17 553 Phone ('110 63X- 7276j <br /> Phone 1 5��� 37D - 31gD License Number 0-57 *- 5s T 171 L <br /> (Permittee) <br /> Pursuant to Chapter 12 . 12 of the City of Ripon Municipal Code and all the <br /> terms, conditions, and restrictions written below or printed as general or <br /> special provisions on any part of this form, and/or attached hereto, <br /> PERMISSION IS HEREBY GRANTED TO: <br /> (Attached two sets of plans or sketches if applicable) <br /> PLEASE READ THIS PERMIT CAREFULLY . KEEP IT AT THE WORK SITE . To arrange <br /> for an inspection, phone 599-2108 at least 48 hours prior to construction. <br /> Your attention is directed to the general provisions printed on the back of <br /> this form. This permit is to be strictly construed and no work, other than <br /> that specifically mentioned above, is hereby authorized. <br /> This permit shall be void unless the work herein contemplated shall have <br /> been completed by , 19 <br /> Accepting this permit or starting work hereunder shall constitute <br /> acceptance and agreement to all the conditions and requirements of this <br /> permit . <br /> Signature of Permittee Director of Public Works <br /> B �%� �� By : <br /> ,co2 DgtEJ- QAMEy <br /> Permittee or Authorized Agent <br /> PERMIT NOT VALID UNLESS EXECUTED BY DIRECTOR OF PUBLIC WORKS OR HIS AGENT. <br /> WORK COMPLETED : <br /> Date By: <br /> White-File Yellow-Inspector Pink-Applicant <br />