NIM : ..............................................................................
Tempat/Lokasi : ..............................................................................
Judul : ..............................................................................
Bukit Jimbaran,
Pembimbing I Pembimbing II
(___________________) (______________________)
NIP. NIP.
Mengetahui,
Ketua Jurusan Teknik Sipil
( Ir I Wayan Arya, MT )
NIP. 196509271992031002