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i <br /> Expense J®.b ® Site Information for non-estimated work) <br /> PM# _124 6!A 6917 9y c-0I-MbLtw tEK <br /> Name& Lan ID: LAId CNAP/Vk A J - I FGZ <br /> Address: _SSD SOV-1-14 _ Ahlj5s.4 ' <br /> City or County name: S"x_,�1 O fJ <br /> CPA: <br /> CPA map attached? o VES o NO <br /> Description of work needed: KEPAVE 2_X S �AF—H Lr o4 FIWIT or 3-40 S. DAkiE <br /> AVE Ai Tr'2 e-As MAal kc—ft ES <br /> Work Location Sketch <br /> 32a <br /> S <br /> dol LAV-e <br /> , <br /> ---------- 550 --s{ <br /> Excavation Location Sketch Requirements: <br /> 1. Provide dimension from cross street 1 and cross street 2 <br /> 2. Dimension should reference as back of walk,edge of pavement or center line <br /> 3. Indicate North Arrow <br /> I <br />