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mum :Ui r ur nirury a Li0'y b'y'y-Lb[ib <br /> PUBLIC WORKS DEPARTMENT No. No 1226 <br /> 259 N. Wilma Avenue <br /> Ripon, California 95366 <br /> 209-599-2108 <br /> ENCROACHMENT PERMIT <br /> TO: Name Nestle USA, Inc. Date issued 111p,.t Db <br /> Address 800 North Brand Boulevard Contractor Precision Sampling <br /> Glendale, California 91203 Phone (510) 237-4575 <br /> Phone (818) 549-5948 License Number 636387 <br /> (Permittee) <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 15 HEREBY GRANTED TO : <br /> Direct push two boreholes to approximately 24 feet below ground surface, then <br /> tremie grout the holes to the surface in the City right of way on Industrial Avenue <br /> in Ripon, California <br /> Locations are noted on the attached sketch and labeled as OB-2 and OB-4 <br /> (Attached two sets of plans or sketches if applicable) <br /> PLEASE READ THIS PERMIT CAREFULLY. KEEP IT AT THE WORK SITE. To arrange <br /> for an inspection, phone 599-2108 at least 48 hours prior to construction . <br /> Your attention is directed to the general provisions printed on the back of <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 . 19 <br /> Accepting this permit or starting work hereunder shall constitute <br /> acceptance and agreement to all the conditions and requirements of this <br /> permit . <br /> Signature of Permittee Director of Public Works <br /> By: By: 1 /f <br /> rMr inittee or uthorized Agent <br /> PERMIT NOT VALID UNLESS EXECUTED BY DIRECTOR OF PUBLIC WORKS OR HIS AGENT. <br /> WORK COMPLETED: <br /> Date -BY- <br /> While Fila YellaW-Inspector Plnk•Applic nl <br /> 11/09/00 THU 10:37 [TX/RX NO 50981 2002 <br />