Laserfiche WebLink
'J <br /> T PriCn`ir(as'71xl Field Paving Form Permit Number: <br /> Llocide Company Permit Expiration Date; <br /> Date: _ 1 Q 4 / J' CY Street Address: <br /> Foreman Name: t, Cross Street: ,� k 1.4 Ohl Yn <br /> PM Number: CityXounty: <br /> Concrete W x L Depth <br /> Roadway _inches <br /> Sidewalk —inches Color.Y I N j Aggregate:Y I N Decorative/Stamped:Y I N <br /> Sidewalk —inches Color:Y I N j Aggregate:Y I N j Decorative/Stamped:Y I N <br /> Driveway inches Color:Y I N j Aggregate:Y I N DecoragvelStamped:Y I N <br /> Driveway _inches Color:Y I N j Aggregate:Y I N Decorative/Stamped:Y I N <br /> Curb Ramp Domes:Y IN <br /> Curb If Gutter:Y 1 N <br /> Valley Gutter If <br /> Dowels ea Size:#41 ##5 <br /> Asphalt W x L Depth Adjust/Replace <br /> sphalt ,2.inches Manhole Frame ea <br /> S, Fill _inches Sidewalk Gas Valve Box ea <br /> Asphalt I Concrete Combo _'over Secondary Electrical Box ea 13°x 24"j 17'x 30'J 24'x 36' <br /> Grind inches Valve Frame ea 15' 123' <br /> Asphalt Fabric Valve Cover ea 30'x 30'132'x 32'j 48'x 48' <br /> Asphalt Berm I Curb If <br /> Saw Cut Depth Other W x L <br /> Asphalt 1 If 3 inches Place Paver 1 Stone I Brick In Concrete:Y 1 N <br /> ncfete �if inches Traffic;Marker Dols ea Reflective:Y I N <br /> Seal W x L Plug•I %:°Gas Prospect Holo Hea Concrete Asphalt <br /> Slurry I Fog 1 Sand <br /> Striping Width Notes <br /> Paint If _-inches _ <br /> Thermoplastic if inches <br /> Traffic Legend ea <br /> Double Center Lane If _ <br /> 3M'Scotch Lane" If 4'18'112'Crosswalk <br /> b <br /> i� <br /> �.� t:- `r <br />