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' S <br /> PUBLIC WORKS DEPARTMENT No. <br /> 359 N. Wilma Avenue <br /> Ripon, °California 95366 <br /> 209-599-2108 <br /> ENCROACHMENT PERMIT <br /> TO : Name �` :�l �fj`�� Date issued J <br /> • <br /> , i �lLr1{ ��ja'L ��' {:i��'G:lu� �,, ,r j��} (� yt�"iIw <br /> Address Contractor <br /> Phone <br /> Phone ` yy 3 License Number ! n ' 4 <br /> (Permittee) 4: lle-iv <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 /> f r XI A s l\/ �57;2 QCT / /V <br /> (Attached two sets of plans or sketches if applicable) <br /> PLEASE READ THIS PERMIT CAREFULLY . KEEP IT AT THE WORK SITE. To arrang <br /> for an inspection, phone 599-2108 at least 48 hours prior to constructio <br /> Your attention is directed to the general provisions printed ori the back—ofl <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 J 19r/ <br /> r <br /> Accepting this permit or starting work hereunder shall constitute <br /> acceptance and agreement to all the conditions and requirements of this I <br /> permit . <br /> Signature of Permittee Director of Public Works <br /> By'. <br /> B.> � ' <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 I <br />