Laserfiche WebLink
THE APPLICANT HEREBY CERTIFIES: <br /> 1. That he/she has read all the provisions of this application,and that the description included in this application are correct to the.best of <br /> his/her knowledge;and <br /> 2. That he/she is the owner of the respective property,or is qualified to represent the owner;and <br /> 3. That he/she wilt assume full responsibility for all liability for persona;MJury or damage to property which may arise out of the work <br /> described above,or which may arise out of his/her failure to do the work provided herein;and <br /> 4. That in the event any claim of such liability is made against the County of San Joaquin,or any department,official or employee <br /> thereof,he shall defend,indemnify and hold them and each of them harmless for such claim;and <br /> 5. That work shall be performed by the applicant and/or any representative of the application in the County-Right-of-Way at the above <br /> indicated site with valid San Joaquin County Encroachment Permit,and <br /> 6. That if permission is granted as requested,he agrees to do the work described in accordance with all terms,condition and restdc on <br /> of thi4� attached sheet,included as general or special III provisions. <br /> � <br /> re of Applicant Tr e ate <br /> »»»»»»»»»»»»»»»»»»»»»>FIEt_D t# ECTIONCCOMMENTS«««««««««««««<<«««««««« <br /> EMNG Ct31! ITION5 <br /> 1. DRIVEWAY: None ❑ Dirt Gravel ❑ Aggregate Base ❑ Paved(poor) ❑ Paved(good) ❑ <br /> 2. SLOPING: Away from Pavement ❑ Towards Pavement ❑ Flat <br /> 3. PIPES: None Existing—Type <br /> Othe Ipes in neighborhood: Yes No LJ Approaches LJ Cross Drain Size <br /> 4. HEADWALL: Yes ❑ No <br /> 5. ASPHALT CONCRETE DIKE: Yes ❑ No <br /> 6. BARRIERS: along Right-of-Way <br /> 7. DITCH: Yes ❑ No JKf Yes: V Style [12 Point 1-1Other El Width Depth <br /> »»»»»»»»»»» >>>""""»>>>>>>»»»»»»»PERMITS REQUIREUEf'f <<<<<<«««««c««««««««««< <br /> 1. DRIVEWAY: SFR ercial ❑ Agriculture ❑. Industrial <br /> Paved with "Min Depth A.C.over "Min Depth ✓e A.B.over <br /> , <br /> Notes: <br /> 2. PIPES: Length of Pipe Required Ft.and meter of Pipe inch(es) <br /> To be connected to any adjacent driveway pi Yes OE] o <br /> Drainage Inlet Required es No ❑ <br /> Total Length: (with pro Total Number of Storm Drain Inlets: <br /> Notes: <br /> 3. HEADWALL: Yes ❑ No ❑ <br /> 4. PAVED FRONTAGE: Paved "Min Depth A.C,over "Min Depth "A.B. <br /> M ring Feet in length and eet in width <br /> »»»»»»»»»»»»>»»»»»»»»»»»»»>FEES«««««<<<<< ««�«««««««««««««« <br /> Driveway Encroachment Permit base fee $90. <br /> Feld Ins tion <br /> Driveway w/or w/o pipe - 102. Paved Frontage $108.00+0.50/ft. <br /> riveway w/box Culvert ❑ Curb,Gutter,Sidewalk $105.00+1.03/ft. <br /> Y..10 M b TEMPLATEMENCR0ACHMENT PERMIT DRIVEWAY.dDC PSW <br /> ams..>.,, ... . .._..............w.,. ............,......,.„ ...,.........,...,..,.,.,..,..,..,w.. <br />