Laserfiche WebLink
HET113LICANT HEREBY CERTIFIES' <br /> _! ,e / she has read all the provision f this application, and that the descrip:i; i-,:'jjed above are corect <br /> ttie best of his / her knowledge; and <br /> - ,at he / she is the owner of the respective property, or is q :aGfied to represent t`,e c:-er, and <br /> -,at he / she v.^II assume full responsibility for all liability fcr personal injury or dmage io property which may <br /> -:se out of the work described above, or which may arise out of his/ her failure to do :`e v:ork provided for <br /> e -i; and <br /> riot in the event any claim of such liability is made against the County of San Joaquin or any department, <br /> «tial or employee thereof, he shall defend, indemnify and hold them and each of than harmless for such claim; <br /> rid <br /> nat no work shall be performed by the applicant and / or any representatives of the applicant in the County <br /> ;fight-of-Way at the above indicated site without a valid San Joaquin County Encroachment Permit; and <br /> "hat, if permission is granted as requested, he agrees to do the work described in accordance with all terms, <br /> -onditions and r •ctions of this a d any attached sheet, included as general or special provisions. <br /> ✓ � a G, Ct \ <br /> (Y Date <br /> Signature of Applicant -Title <br /> FIELD INSPECTOR COMMENTS <br /> »»»»»»»»»»»»>EXISTING CONDITIONS«««««««««««< <br /> DRIVEWAY: None, :"", Dirt Gravel Aggregate Base Paved(Poor) Paved(Good) <br /> SLOPING: Away from Pavement Towards Pavement Flat <br /> — <br /> None None Existing - ype <br /> Others in neighborhood: Yes No� Approaches Cross Drain Size <br /> Attachment to ne'ghbor's pipe: Yes No' <br /> HEADWALL: Yes No <br /> =,SPHALT CONCRETE DIKE: Yes No <br /> 3ARRIERS along Right-of-Way <br /> DITCH Yes No-4IfYes: V Style_ 2 Point_ Other Width_ Depth <br /> »»»»»» »»»»»»PERMIT REQUIREMENTS««««««««««««< <br /> DRIVEWAY: SFR COMMERCIAL AGRICULTURE INDUSTRIAL <br /> PAVED with 2" Min. Depth A.C. over Min Depth 3/4" A.B. <br /> or r <br /> 4" Min. Depth Portland Cement Concrete. <br /> es: <br /> PIPES: Length of pipe Required: See Fo R-17, Note 4 Diaeter of oipe�� <br /> ,n Inch <br /> To be connected to any adjacent driveway pim <br /> pe Ye No <br /> DRAINAGE INLET REQUIRED Yes No <br /> Total Length: (with proposed) Total Num er of Storm Drain Inlets <br /> es: <br /> -ADWALL Yes No / <br /> :RAVED FRONTAGE:' PAVED with�Niri. Depth A.C. over ' 1,17.1. Gep;h 3%�"A.B. <br /> =eat in length and Feet in width <br /> FEES <br /> -oachment Permit-base fee . . . . .S4 <br /> r-,srec'ion w1 or Paved Fro,--!a--e . . . . . . . . 55�.0� 25:" <br /> Driveway w,'O pipe . . . . . <br /> l.. c= OJ Curo, Gu*,:er. �e.:a:ic . . S�O.Gg + .-5�-`t <br /> j Dhve-way w/ Box C ed -- <br />