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OCT-04-2007 18:48 CAMBRIA 1707 935 6649 P.02i02 <br /> J+ v ry GrpVf iU•c- .M1 IOM Irl LrrJr »a oo-47 r-.1.J4�rj1 <br /> Cm OF RIPON -ENG[NEER16IMPARTMENT NO. a f 70 <br /> 259 ldortb VNillnta Avenue,Ripon,CA 95166 <br /> 2091599-2108-Fal: 2"ISW2685 <br /> ENCROACHMENT PERMIT <br /> Applicant's Name: Date Submitted: -/0-o-7 <br /> esviw.Tre COntrRCtOr: /ii Ii" D�Cre1.7'��n <br /> Addirem. "fer�Phane; <br /> p 1. Contact Name; <br /> Pbone; a License Number: C 9-7 as�z <br /> Pursuant to Chapter 12.12 of the City of Ripon Municipal Code and all the terms,conditions,and restrictions <br /> written below or printed as general or special provisions on any part of This form,and/or attached hereto. <br /> PLEASE READ T*US PERMIT CARFFULLY AND KEEP IT AT THE WORK SITE. <br /> I.Provide a full descnivdon of work to be dome at alllocalions. <br /> 1'P,RAfiTssiary is mnsr GRAMWO r'O 2.Attack two k�sets of plans or skerchrr, if applicable. <br /> T' 4A Ake Wi L s� <br /> IISDO.O <br /> Ll <br /> TO ARRANGE F'OR AN INsIpECT10N, pHoNF.209/599-2109 AT LEAST 4$ JJQURS PR401!TO CONSTR{11ClION, <br /> This permit shall be void rimless the work herein described is completed by: o <br /> Orn <br /> Accepting this permit or stavting work herein described,shall constitute acceptance and agreement to all the <br /> conditions and requirements of this permit. <br /> Signature of ApplicaatfFermltRee City E gi�aeer(or authorized Agent) <br /> G1Lo - <br /> -� ,/" <br /> Applieanr/PersniRee or Authorized Agentc Date 1884ed <br /> -3( APPpc-1C-+tjr <br /> NOTE. Your attantiaa is directed to the geaetsl provisions punted aa'tb�t�back of this f form This TY pe=lt is to be std tt1y"�wC L4 <br /> construed and no work,other tbaia thst specificAlly mentioucd Above,is hereby authvrized. <br /> PERNUT NOT VALID UNLESS EXECUTED RY CM ENGINERR OR*US AGENT <br /> Wnlw rnmpl.>K Tin! BY: --- <br /> TOTAL P.02 <br />