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SEP-10-2007 10:24 CAMBR 1 A �"� <br /> 1707 935 6649 P.02iO3 <br /> CITY OF RIPON-ENGINEERING DEPARTMENT NO. it 70 <br /> 259 north VVlitna Avenue,Ripon,CA 95366 <br /> 2091599-1108-raa: '109/599-2685 <br /> ENCROACHMENT PERMIT <br /> Applicant's Name_ Date Submitted: 7-/0-0-7 <br /> �n�tv7a-►.t � i�a „rS �/�Sa�ia7ves Contractor: <br /> Address: 14'YY9 f <br /> 5�� Contact Name: <br /> Phone: -72a17_ !Z_3 %-2_36 I License Number: C 5'7 1kI 9.5 yd <br /> Pursuant to Chapter 12.12 of'the City of Ripott Municipal Code and all the terms,conditions,and re9trictions <br /> written below or printed as general or special provisions on any part of this form,and/or attached hereto. <br /> PLEASE READ THIS PERMIT CAREFULLY AND KEE1P IT AT THE WORK SITE. <br /> UESCRIP�O�F P OJ,EC7:• <br /> I.Provide'a fall description of work to be done at all locgt(ons. <br /> PPIIMISSIOIV IS A.ERSBY GRANTED TO 2.Attach two Q sett of plans or sketcher, if applicable. <br /> /�.a...r ,- QcjGceJ <br /> 16-e^ UC- w:�-L 1 C��t S�r��71' �4CIS -1' S <br /> T V l t' IML-4i t >` t! ter,.J-mJ <br /> 1JS00.0 <br /> a• � <br /> r11111121 Sit /QSU. <br /> TO ARRANGE FOR AN INSPECTION,PHONE 209/599-2108 AT LEAST 48 IIQURS PR10R TO CQNSTRVCTION, <br /> This permit shall be void unless the work herein described is completed by: <br /> Dare <br /> Accepting this permit or starting work herein described, shall constitute acceptance and agreement to all the <br /> conditions and requirements of this permit. <br /> Signature of Applicrant(PervWtttee City E gineer(or authorized Agent) <br /> r�rr q Z` o <br /> Applicani/Permutee or Authorized Agent Date Issutd <br /> ,�,�r�PPc-t cr,,,T �tKs� o a rte►.J �-rt� <br /> ItP QoPPa�h;r<- env.,JTY P4rRM41r-5 7'b <br /> NOTE. Your attention is dimcted to the general provisions print on the back of this form This permit is to be strictly <br /> construed and no work,outer than that specifically mentioned above,is hereby authorized. <br /> PERMIT NOT VALID UNLESS EXECUTED BY CITY ENGINEER OR DIS AGENT <br /> WORK COMPLE'T'ED: <br /> MfNe� fh Yoflow-AnfpedAr pink-Applk.9m <br />