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NOV-06-2003 09:54 MANTECA PUBLIC WORKS 209 239 8495 P.02i02 <br /> . A E�� PUBLIC WORKS DNARTMENT <br /> �'t" *oo35911� <br /> 1001 W. Center Street Np 5186 <br /> �.; Manteca, CA 95337 <br /> ENCROACHMENT PERMIT <br /> Contractor: W L Project Name: �'flaally <br /> License No: 7- - Project Location: 210 N.__1'Y N �+ <br /> Address: Q Ll L 1.0 C <br /> of C,8 ct S 6 g l Date Issued: <br /> Phone: 'NJ "1-1 `l 4 l //_ G `o 73 <br /> VLicense Verified Insurance Verified <br /> Pursuant to Section 12 of the City of Manteca Municipal Code and all the terms, conditions and restrictions <br /> written below or printed as general or special provisions on any part of this for, and/or attached hereto, <br /> PERMISSION IS HEREBY GRANTED TO: l fA Z'rA LL 3 K&oK3%1-oQ.rNt--b Us 4LLq!) <br /> !�"C 5"�P E2. �cod ri,1�r�c,2��r R-t ��o wlot�z u. +►��►.�w �R�t ��2� <br /> (Attach Two Sets of Plans or Sketches, If Applicable) <br /> PLEASE READ THIS PERN4ff CAREFULLY. KEEP IT AT THE WORK SITE. To arrange for an <br /> inspection,phone 825-2309 or 239-8460, at least 48 hours prior to construction. <br /> Your attention is directed to the general provisions printed on the back of this form. This permit is to be strictly <br /> construed and no work, other than that specifically mentioned above, is hereby authorized. <br /> This permit shall be void unless the work herein contemplated shall have been completed by <br /> 12004 , <br /> Accepting this permit or starting work hereunder shall constitute acceptance and agreement to all the conditions <br /> and requirements of this permit. <br /> Signature of Permittee/Contractor Director of Public Works <br /> By: By: <br /> PeLnittel or Authorized A ent <br /> PERMIT NOT VALID UNLESS EXECUTED BY DIRECTOR OF PUBLIC WORKS OR HIS AGENT. <br /> WORK COMPLETED: <br /> Forms�Encroach.doc (Rev. 08/95) Date: By: <br /> TOTAL P.02 <br />