Laserfiche WebLink
THE APPLICANT HEREBY CERTIFIES <br /> 1. That he/she has read 9 the provisions of this app cat W,arid that the descrip6ort Included in this application are correct to the best of <br /> his/her knowledge;and <br /> 2. That heMe is the owner of the respective Prop",or*4"10410 owner;and, <br /> 3. That he/she will assume tail responsibility for all liability for persona;injury or damage to property which may arise out of the work <br /> described above,or which may arise out of hMw erre to do the workprod h fn;and <br /> 4. That in the event any claim of such liability is made t the County of S n Joaor,any d�rr nt,official ore k e <br /> thereof,he shall defend,indemnify and hold them of tfhein I art i for such claim;and <br /> 5. That work shall be performed by the applicant andlor any re_presentave of the appilostion in the.County-R#ft-of-Way at the <br /> indicated site I with a valid San Joaquin County Encroachment,tem*and <br /> 6. That if permission is granted as requested,ire"s to do ft,wbrk'described in acccoplance wt h all tens,oort ` arid restdr n. <br /> of this and any attached Wit,inolucled as or #t pions, <br /> at re of Apia t Ie ` 3ate <br /> »»»»»»»»»»»»»»> >�>>�s»» l .l? t«t««<<< «<c«««<<c<<<c«««««<<<< <br /> 1. DRIVEWAY: None ❑ Dirt ❑ Gravel [ Aggr;te B e ❑ Paved(poor} ❑ Paved(good) <br /> 2. SLOPING: Away from Pavement ❑ Towards Pavement Flat <br /> 3. PIPES: None &'Usting-Type <br /> Other pipes in neighborhood Yes No -Approaches U Cross Drain U Size <br /> 4. HEADWALL: Yes ❑ No 'k' <br /> 5. ASPHALT CONCRETE DIKE: Yes d No <br /> 6. BARRIERS: along Right-of-WayJL <br /> 7, DITCH: Yes [] No a If Yes: V;Style ❑ 2 Point ❑ Other EJ Wift D <br /> »»»»»»»»»»»»»»»»»»>y»»»»»PER "M lit, - S«««<«««««««««««««««<«« <br /> 1. DRIVEWAY: SFR ❑ Commercial dcditure ❑ Indus Tial n <br /> Paved with "Mich Depth A.C,over "Mn Bep1 hiW"A.B.over <br /> Notes: yXtt rvv` Z <br /> 2. PIPES: Length of Pipe Required Ft.and Diameter of Pipe inch{ j <br /> To be connected to any adjacent driveway pipe Yes ❑ N <br /> Drainage Inlet Required Yee ❑ No <br /> Total Length: (with proposed) Total Ntihftr of Starch DrainInlets: <br /> Notes: <br /> 3. HEADWALL: Yes ❑ No <br /> 4, PAVED FRONTAGE: Paved with "Min Depth A.C.over °Min Depth V A.B. <br /> Measuring Feet in length and Feet in width <br /> »»»»»>»»»»»»»»»»»»»>»»»»»»»»FEES««<z««««««c««<<<<<<««««««««<<<<< <br /> Driveway Encroachment Permit base fee $90.00 <br /> Field Inspection <br /> Driveway wl or w/o pipe $102.00 Paved Fronto $#08.00+0.5fllft. <br /> Driveway w/box Culvert $167.00 Curb,Gutter, walk $145.fl0+1.031ft. <br /> YAMFUS 3 TEMPLATMENCROACHMENT PERMIT DAftVAY.d"c(0M) <br />