Laserfiche WebLink
1. That he/she has read all the provisions of- apt <br /> Wier kwWbctr,- <br /> That <br /> v toff r specon <br /> �e is ,,OFiso <br /> 3. Thai W-Rhe ygasWW", <br /> Ir <br /> 4. That in the eventarmcrot or <br /> thereof,he shall <br /> 5. <br /> andbr <br /> r <br /> 6. oft i quested-, tocb � <br /> 1. DRIVEWAY: None LW"" Dirt Q Gam} Q �9g .Base Q Pam } Q I'ava�� �( . <br /> 2. SLZWG: Awefro�nP1t To�daavernerst ] Flat Q <br /> 3. PIPES: None &'E;ftwV-OffiTaw <br /> erpipesinnevaorhow: Yes No Crams EIt SSze <br /> 4. HEADWALL- Yes ❑ No <br /> 5. ASPHALT CONCRETE DIKE:. Yes ❑ No <br /> 6. BARRIERS.- dong Right- W <br /> 7. DITCH: Yea ❑ No iYk v ❑ 2 Point Q comer Q Wa D <br /> »»»»»»»»»>,>>>>>>>>>»»»»>>»»»»» �<e<ac«««c««<c< <br /> 1. DRIVEWAY SFR fid Carnet at ❑ Agrlau!W ❑ qua tat ❑ <br /> Paved with `� 'tin Depth A.C.averOw <br /> Notes:; w 1 . <br /> 2. PIPES: Length of Pipe hired Ft and Diameter of Ike <br /> To be connected to any <br /> a*r,�tt driveway PteYes Q No , <br /> Drainage Inlet Re"red yes ❑ No <br /> Toth Length: ' {with proposed) Totat Nober of Storm Drain Inlets: <br /> Notes: <br /> 3. HEADWALL: Yes F1 No [ <br /> 4, PAVED FRONTAGE: Paved with 1,11A Mn <br /> Measuring Feet Depth A C: Mitt �"AA' <br /> 3 <br /> Feetth <br /> Drive"Encroachrnen#P"amit base fee $125.00 <br /> Fief hispecdon <br /> DrivewayET w/or w/o <br /> Drivewy w/box Culvert $1`79.00 si1BI � <br /> ° P ar wAYat)c nam} PSO9 t2 <br />