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1. 11ri1C f18Y64u neer•were as uw trsvrmarue vs uvn syy+..�...w.q w...uw.w uwaeajnau�a irw+...w,a......-rr-----------_�_�••»__-��--. <br /> kww and ., <br /> 2. That lhe/she na the OV=oftha MPOdlvo prnpaty,a is gwfiSiedto vW sat 9aaovgnm and <br /> 3. That he/she will assmm fill raspaa i fir aft Bilary Expecimd xgwy<wdamage to property ve"a ay arise at cftbe wodc desra'bed above, <br /> or which may arise out ofNs&ea W nre to do&e wo&pcovidai herein;and <br /> 4. That in the oval any claim of such y is made egoist#wC,onaty of sera]m4m err ay. a�Ciat err eabuyae thereof;ha shall <br /> 44 indemnify and hold and each of them hamhbss far M& erre/ <br /> M44 <br /> S. Mit work shall be pechmed by the appliawt and/or any nwasentWft of flhe applicant in the County Ri&4 Way at the above indicated site <br /> widh a valid San Joagnia County Fnaoadaaeed Permit;and <br /> 6. That if peaminion is Wanted as roque94 he agrees to do the wodc deem'bed inacoordaace vA h all temps,000datdoos and stridden afihis and any. <br /> n/ M 3 © o <br /> afApp}icar�-Ti3te (Dole, <br /> FD&I.D INSPECPOR COl♦611dTRM <br /> »»»»»»»»»»»»»»»»>}»»EMS'i:MOCONDi110NS«««««««««««««««««««« <br /> L DR&MAY: Naos ❑ Drat ❑ Grave/ � Aggregate Base ❑ Paved(Poa) ❑ Paved(Oood) ❑ <br /> 2.SLOPINCe AwayfromPavaomt ❑ TowardsPawmaot ❑ Flat <br /> 3:PZM:. Nene Emoting-Type <br /> Otherpipw inneighbodood: Yes ❑ No Approaches Ccou Drain ❑ Sim <br /> Aitacbma t to apipe: Yee ❑ I <br /> A.EMADWALL: Ya ❑ No <br /> S.ASPHALT CONCREM D=:� Yes ❑ Na <br /> &RARRI13EtS ak"RWd-c&W,* <br /> 1.DUCE Yee ❑ No Iffea:• V Style ❑ 2 Point ❑ Other ❑ Waft Dep&. <br /> »»»»»»»»»»»»»»»»»»»PERI ITREQUM <z««««««««««««««««««« <br /> L DRIVEWAY: OR COMMEWJAL ❑ AGRiCULTU" ❑ INDUMVIAL ❑ <br /> PAVED with. Z- "h6a.Depth A.C.over "lfim Depth 3/4"A.R <br /> Nates <br /> 2. PIPR& LAD&1hofPk-Regajred: • Pt and Diamoor of Pipe irhoh <br /> To be.00meciedtoany adjacent ypipe Yes ❑.N% <br /> DRAINAAE DIIET REQUIRED Yee ❑ No <br /> Tow Lang& (with pmvposed) Tataif Number of Stela DrWk Ii <br /> Nates <br /> 3. HEADWALL Yee Q No <br /> A ?ATM FRONTA VX: PAVED with "Wm Dept A.C,over "Wm Dm&3/4"A.D. <br /> Meas u* Fed in les49Qa and Feet in vAft <br /> . _ FEES <br /> Driveway Fnaoachment Permit bele fee <br /> pim (� <br /> w/or w/o pipe..... 593. ❑Paved +0.46/R <br /> ❑ nrivewayw/bos ah�v«t__ _._ _r.slss oo ❑cork cater,sidewak ..............._S300:oo+0.9&* <br /> Caunftalomputoc,c.V cwsslAppliaatim far PacmilslDdyeway and Paved Frontage Page.2 of 2 ltevisad 8/2000. <br />