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PUBLIC WORKS DATMENT 40 <br /> 1001 W. Center Street <br /> CA 95337 N� /�_ 4T�Qs <br /> (PiManteca, <br /> ENCROACHMENT PERMIT <br /> Contractor: 1A11 L'"-9l/ 4dxvv&>- nart17— <br /> _40 I � L, I/ Project Name:_DJonx�isn <br /> License No: Q r 100 Project Location: <br /> 7-1 <br /> Address: <br /> 2533 Date Issued: 24f <br /> Phone: ZO 9 �'Z. 3 - 31 Z <br /> License Verified Insurance Verified <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 IS HEREBY GRANTED TO: <br /> 14� <br /> A% low �r 25 <br /> P l Zd 4 <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 843-3302 or 23g_g460 at least 48 hours prior to construction. <br /> � i-�1(A_ 4549-8413 <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 shall be void unless the work herein contemplated shall have been completed by <br /> , 20L. <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: <br /> YOR <br /> �9 nT 9✓Y� <br /> Permittee or Authoriz Agent <br /> 9 - 9e/U � 5 L/7 <br /> P IT NOT VALID UNLESS EXECUTED BY DIRE PUBLIC WORKS OR HIS AGENT. <br /> WORK COMPLETED: <br /> Forms\Encroach.doc (Rev. 08/95) Date: <br /> By; <br /> J 6 J"JW1 G(308)]8&]118 <br />