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Expense Jo.b m Site Information ( for non-estimated Work) <br /> pm# y Z 9 o°t U7 g c� CAr�T2o Lsur� <br /> Name& Lan ID: LAN WA?t4AM IF6_7_ <br /> Address: la3R 5. ApEac- r Ave. :�Tocic-roeJ <br /> City or County name: STo6k7_0^1 <br /> CPA: <br /> CPA map attached? ❑ YES ❑ NO <br /> Description of work needed: WAVE 4 AT"A5MAt.-r T t1v S. ApgLAgei <br /> Work Location Sketch <br /> Z� <br /> OJ' <br /> 47" <br /> , <br /> --------------------;-------------------- - -- - - ---y----------------------------------- <br /> �- ------------------ <br /> D"n, <br /> Eop <br /> M <br /> y <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 />