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- <br /> kmwlwd8a;and <br /> 2. That he/she is She owner of Ste respective property,ar is qualified to represent the owner;and <br /> 3. That bloke will assume fall repavaiMity for all.tiaii1lily fwperaonai i gmy err damage to properly vahichmay wise out cftbe work desdalmd above, <br /> orwhich may arise out of Ns&w fa k e to do go work provided hanin;sad <br /> 4. That inthe eveat any daim of suchNdQk"y is made WindgwComAy of&m l ,*m oranydem official or anplaym therooiy be droll <br /> defend,mdemni:jr and hold*=and each of them bshmlessfor such claims and <br /> S. That work shall be performed by to appUc a*and/or any rnpresatative of the applicant in the County Rim Wsy at the above indicated site <br /> w&a valid San Joaquin County Fiat Penal and <br /> b. Tint if permission is Matted as te4usted,]he agees to do the work deamled kacoadanoe with aft tea ns,conditions and roman offi&and any <br /> atffiched sheet,iuchtded asgmamLarapeclakin <br /> 8iglat�trafAf►p1;ce�-Tifie .Dabs <br /> FIRM I1NSPFCTOR COTOAENTS <br /> »»»»»»»»»»»»»»»»»»»EXiB'iTTN3CONDTTKMS«««««««««««««««««««« <br /> 1.DXXWAY: Nana, D ❑ } Gmvsei ❑ .AggagdeBase Paved(P") ❑ Paved(Oood) ❑ <br /> 3.SLOPINGe AwayEmmPavement ❑ TowardsPavaemam ❑ Flat <br /> 3:PIM:. <br /> Fa vft-Type <br /> ONnrpipesinna0bodaoo& Yes ❑ No Appmachm 0 . Cross Drain ❑ Size L�J <br /> Attadmreatln neigiboc4Yes ElNo <br /> 4.HFADWALL. Yes FlNo' '. <br /> S ASPHALT CIONCRETII DEM-' Yee ❑ No <br /> 6.BARRHERS aloagRWA,&Way <br /> 9. DTPCIH Yes ❑ No IPYes:• V Style p 2 Foist ❑ Other ❑ Width Depth <br /> ««««« <br /> L DIMWAY: SFR AORk%JLTLMk ❑ INDiJMMAL ❑ <br /> PAVED with. r' - w Esso.Depth A.Q over "Ilio Depth 3/4"A.B. <br /> Nates <br /> 2. PIPM LAng*of Pipe Regal• Pt.and Diameter of Pipe inch <br /> To be.ocooected to any a3acest*'WOMY pipe Yes No . <br /> DRAINAGE INLET REQUIRED Yes � No <br /> Total Length: (with propmd) Total N®ier of Sbum.Dr da Faliels <br /> Nates <br /> 3. MUDWALL Yes 0 No <br /> 4L PAVED FRONTAgE: PAVED with "Idno.Depth A.C.over "AfmL Depth 3/4"A.R <br /> Measuring Fed in feng8h and Feet iu wid@h <br /> FSFS <br /> Driveway Emoachnu t Permit base flee................__.585. <br /> • <br /> r�t� <br /> FieldInspection . <br /> t�ivewayw/or w/o pipe........._ _ _ `_59 _ ❑Pavedfinotaga.—..._.....:_..............simm+0.46/& <br /> ❑ Drivowayw/bos CafvaR__ _ _ SiS3.00 ❑Curb,Ower,Swma> ----......:...........S300:00+098/8 <br /> CavltalComputa;o:lAcceaeAplioation fur P1Driyeway and Paved F+roatage Page.2 cf 2 R,evited 812000. <br />