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Expense J®.b m Site Information ( for non-estimated work) <br /> PM#_ 3l( SSSS(vl <br /> Name& Lan ID: <br /> Address: 4"T q X1 5601 d SL O C.LA KE. A.yt Is,oGK:—j 0,pJ <br /> City or County name: S7-bc K60—/� <br /> CPA: <br /> CPA rnap attached? ❑ YES ❑ NO <br /> Description of work needed: KZPAUE Q',KLO AS1'tfALI -AEMK. 64S CEPAI9, �,bfa� <br /> Work Location Sketch <br /> V <br /> y <br /> 5 G KE AVE . <br /> ----------------- <br /> --4-F77 <br /> raz'�► <br /> o <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 />