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�� \� rt�{N�4KN 5 raZ bOS <br /> ZPTY OF RIPON-ENGINEERING DEPARTMENT No. 3321 <br /> 259 North Wilma Avenue,Ripon,CA 95366 <br /> 209/599-2108-Fax: 209/599-2685 <br /> ENCROACHMENT PERMIT <br /> Applicant's Name:� ( Date Submitted: <br /> 'G A�jOIY-e7 RP <br /> AA /J Contractor: MSIMt1 t matni,�c— <br /> Address: I'AIIt�i- IAl'te'P6tIY AVe JIe,10 Phone: (� "[>9� <br /> ) - R12 <br /> YVLoky aA "18381 Contact Name: _11n1 kjdi4do{ ( <br /> Phone: 01) 521--M License Number: a-54 <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 THIS PERMIT CAREFULLY AND KEEP IT AT THE WORK SITE. <br /> DESCRIPTION OF PROJECT.• 1.Provide a fall description of work to be done at all locations: <br /> PERMISSIONIS HEREBY GRANTED TO 2.Attach two(2)sets of plans or sketches,if applicable. <br /> -tPP,porertl <br /> Mow, of kasf dura sib 'Ihru V uor] e o 111 4he, rmer rVltlrls Aq bjry <br /> Z'�Sr��ck-�rl f}y2 . ��r�he��e�lnru�� Ike gttsoftnc (1i��li r(.t'i grnuadaa�/ P-�navtafirtf �rct>1n 1tie <br /> -�orrrtef��ermanr7's�'vc NXa�I S�mnd�F "1"he�lir�p�rnry�nrw tilyoncec��O Gs �c�wq,��,�� <br /> ^ � <br /> ? x <br /> YJJ xx t� z <br /> TO ARRANGE FOR AN INSPECTION,PHONE 209/599-2108 AT LEAST 48 HOURS PRIOR TO CONSTRUCTION <br /> This permit.shall be void unless the work herein described is completed by: <br /> Date <br /> Accepting this permit or starling work herein described, shall constitute acceptance and agreement to all the <br /> conditions and requirements of this permit. <br /> Signature of Applicant/Permittee City Engineer(or authorized Agent) <br /> ( Map rlAI <br /> A icant/Penm� razed Agent Date Issued <br /> NOTE: 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 /> PERMIT NOT VALID UNLESS EXECUTED BY CITY ENGINEER OR HIS AGENT <br /> WORK COMPLETED: BY: <br /> WhatFile Yellow-Inspector Pink-Applicant <br />