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PUBLIC WORKS T ,kRTMENT <br /> Manteca=r. 1001 W. Center Street v <br /> �,. Manteca, CA 95337 N 6425 <br /> ENCROACHMENT PERMIT <br /> Contractor: G g,-*?J,-,� �uN j�.1�,��;�, Project Name: 13 a�7-e�f �la n t'e-,A <br /> License No: Project Location: J'/q <br /> Address: K!Qai, Su, e-6 <br /> c-,-y 9 f 3 y Date Issued: <br /> Pho e-: (, 3 e.e—-/(d a ( <br /> License Verified � �Sck* X E%_U-"k? Insurance Verified <br /> J <br /> Pursuant to Section 12 of the City of Manteca Municipal Code and all the terms, conditions and restrictions <br /> written below or printed as general or special provisions on any part of this for, and/or attached hereto, <br /> PERMISSION ISHEREBY <br /> _GRANTED TO:/ /, �+ <br /> y V G'�^ /til Z 1✓j(i/�J � d✓J7 G�/ e, �i✓a[� j' �- Gmca <br /> race ''e=lam r�i.�-i��r� �� a ✓'� e� �.�- ?/'/�- %�i y Pl f i '� <br /> / •� bLr4Ci✓J� lQl�1C' cJ�' J <br /> 7— G �J�✓'r++�,J %�I �� C+Y i l� <br /> G `I <br /> vl e r-2r <br /> (Attach Two Sets of Plans or Sketches, If Applicable) <br /> PLEASE READ THIS PERMIT CAREFULLY. KEEP IT AT THE WORK SITE. To arrange for an <br /> inspection, phone 825-2309 or 239-8460, at least 48 hours prior to construction: <br /> 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 /> This permit void unless the work herein contemplated shall have been completed by <br /> �v <br /> . 206(b .. <br /> Accepting this permit or starting work hereunder shall constitute acceptance and agreement to all the conditions <br /> and requirements of this permit. <br /> Signature of Permittee/Contractor Director of Public Works <br /> By: By: \ <br /> Permittee or Authorized Agent <br /> PERMIT NOT VALID UNLESS EXECUTED BY DIRECTOR OF PUBLIC WORKS OR HIS AGENT. <br /> WORK COMPLETED: <br /> Forms\Encroach.doc (Rev. 08/95) Date: By: <br /> J&J PRINTING(202)236241B <br />