Laserfiche WebLink
&.: .c- <br /> ' Pacific Gas and Field Pavillg Form Permit Number: <br /> ' <br /> Electric Company Permit Expiration Date: <br /> Date: l~ ' LStreet Address: <br /> Foreman Name: A/a✓� ��'--y✓l r M Cross Street: f� tGI 71!�i <br /> PM Number: �j-IZ3°�'1O Ci County. _ >1Jyr� <br /> doncrete W x L Depth <br /> Roadway —inches <br /> Sidewalk _inches Color:Y/N I Aggregate:Y/N Decorative/Stamped:Y/N <br /> Sidewalk —inches Color.Y/N Aggregate:Y/N Decorative/Stamped:Y/N <br /> Driveway _inches Color:Y/N Aggregate:Y/N Decorative/Stamped:Y/N <br /> Driveway —inches Color:Y I N Aggregate:Y I N Decorative/Stamped:Y/N <br /> Curb Ramp Domes:Y/N <br /> Curb If Gutter:Y/N <br /> Valley Gutter If <br /> Dowels ea Size:#4 1 #5 <br /> Asphalt W x L Depth Adjust/Replace <br /> Asphalt inches Manhole Frame ea <br /> Mill&Fill _inches Sidewalk Gas Valve Box ea <br /> Asphalt/Concrete Combo _"over— Secondary Electrical Box ea 13"x24"117"00"124"06" <br /> Grind _inches Valve Frame ea 15' 123" <br /> Asphalt Fabric Valve Cover ea 30'x 30"132'x 32"148"x 48" <br /> Asphalt Berm/Curb pf <br /> Saw Cut Depth Other W x L <br /> Asphalt Bif -inches Place Paver/Stone/Brick In Concrete:Y/N <br /> Concrete If inches Traffic Marker Dots ea Reflective:Y/N <br /> Seal W x L Plug 1%2'Gas Prospect Hole Jea Concrete 'Asphalt <br /> Slurry/Fog/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" 12"Crosswalk <br /> ; J <br /> IV <br /> V � <br /> ILq <br /> } .5 <br /> £d � t4 SLI�r I <br /> 11(7�'r►� <br />