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+. li]aiRONleLl18regp an U46 p7vvsuarLn vs,.,an oy Oeua liana alio ua�oa.a�.aa.,Q�4 j....._. <br /> Icnovvh dgq and ' <br /> 2. That hdehe is the oWAW of&,respediye <br /> P'XtY,or is qualifiedto rep + theovme� <br /> 3. That bAfshe will assume flit(m;for ail lisbgity <br /> forpenma or which may arise out afNejor�,e to do ffie wadc pt�rvided wand rdaaa,ap to WgxXty whichmsy wise out ofthe va&desrn'bad above, <br /> 4. That in theevmtany clam ofaudt Nabdityi$maje agaim,tte <br /> venty <br /> defan4mdmmWandholdtimmeaaeachafthemharml.fo,� 48Mkaq'm oraay o�ialoramployeath he s]1 <br /> S. That work shall>o �and <br /> whh a valid San Jo ys t�aPP1 t and/or say n°pa iVe of the applicant iu IMS. That ifpacmis� ,md e Y1Zigl�of--Way at above.indicated site <br /> . s�ched aTaeet,included se �t'e4�eci,hma grees to do the wank d ia:ooaadsnoe q�all <br /> .8�'+l of special m Smis ftna,Conditions andr.esWafim offhis and say <br /> 8igrfiftl,tr ofTMs. <br /> -------------- <br /> Date, <br /> »»»»»»»»»»»>>>>>>>>>>>>>> <br /> >>}»>>>D 1N8PEGTOR GO) 'Cg <br /> I.DRATWAY: «««««««««««<<<< «««< <br /> 2.8IA mQ N� l ❑ Gataed k ❑ Agg"ate Base ❑ <br /> Ap <br /> YAIMIRavamad ❑ Towaadspavasmeak ❑ A°°�P ) ft"d(Oood) ❑. <br /> 3:mm:. Now .E*g g-Type �� <br /> l2 Ca�uc2r<�-E 6 <br /> ��Pmm� Yes ' <br /> Af nac+ntto NO Appnmchm ❑ Gma Mai. <br /> Y. ❑ ❑ Sias <br /> 4 HFADWML. No <br /> Yee ❑ No' <br /> 3.ASrNALT CU C Di .., <br /> Yes ❑ No <br /> 6..RARREM °kftlhght-,3f.Wq <br /> �. DLTCH Yee ❑ 1% <br /> Ifl'es• V8tyle ❑ 2Fbid ❑ Omar <br /> »»»»»»»»>»»»>>>>> »»>per. ❑ Depth <br /> j-DIaVEWAY: SFR ,�,/ CO�CLAL REQUUUMMM«««««««««««««««««««« <br /> PAVEDwith. 2 " AORfCtJtT'ETi ❑ IIdDL)3Tgfa,L, ❑ <br /> ---- 1 �hAGover <br /> Na4 <br /> ss Mim Depth 3/4"ALR <br /> 2. LEGE <br /> . T� dto4°�a'°d: _--�----�—Pt.and Diamfalar of pipe <br /> a°5'aclfaoent* Inch Yes 0 No <br /> DRAINAOET U'rR D <br /> Total L,mgth (� <br /> Yes 0 No <br /> Noise Paopaeed) Toed Ndsa6er erstam Tail <br /> 3. HEADWALL <br /> Yes No <br /> 4L PAVED FRONTAGE: PAVED with <br /> --=—_� Depth AC,over <br /> aL Feet is k"&and D0 3/4"AB <br /> Fad in widen <br /> priveway huxuachmu t Pam*base fee... . FEW <br /> ❑ Dnvewayw/Ww/opipe_...__ _ <br /> Pavedfroutags-- +0.46/ft <br /> CO irter,c' MMIApp�4ian for •Outtee,Sadewati�.. _aSL00:00+09&M <br /> P«m�4naveway and Paved Frage <br /> Paee.z oft <br /> .z <br />