Laserfiche WebLink
irontsrr�i.tf�.vl tiLlf.Lli Ii �-�.iCl�i@;,1: <br /> 1. That he/site has read all the provisions of this appiicaticq and that the description includedieibis application ate coined to the bat of Iris/her <br /> knovrlwdge;and <br /> 2. That he/she is the owner of the respective property,or is qualified to represent the ownw,MW , <br /> 3. That he/she will assume full resPosihility for an fiyboWty¢rpUMMI iWiry cxdama8'e to property whichmay arise out ofthe work described above, <br /> or which nuy arise out of his/her failure to do the work provided haver;and <br /> 4. T hat in the evert any claim of such liabiltly is made against thcConnty of San Aima ar aay depairtmenk of$ciai or enVk*w&ereot he shall <br /> defend,MA=mfy and hold- em and each of them harmless for sash clew and <br /> S. That work shall be peforumd by the applicant and/or any relzesentatiVe of the <br /> with a valid San J in the Cosnty Right-of--Way at the above indicated site <br /> QaNm Cly E�'ondm�eot Pastil;and <br /> 6. That if PPAffik is grmted as requested,he agrees to do the wank&BMIW is <br /> AWMhooe with alt tams,conditions and rvahiction of this and any <br /> attached included as <br /> S* ofmt-Tifle <br /> Dalt <br /> FIELD INSPECTOR COMMENTS <br /> """""">>>">>>>>>>>>>>>>>>>>»»>>EXIST1140 CONDITIONS«««««««««««««««««««« <br /> L DRftWAY: None t <br /> - • � ❑ Gmvel ❑ AWvSde Ban ❑ Paved(pow) ❑ Paved(Good) ❑ <br /> 3. SLOPING AEcTyp <br /> um Paaameor ❑ Towards Pavement ElF7at <br /> 3: PIPES:. Nano Existlog- eOdwPiPes _ <br /> mneiglrbothoo Yes ❑ No Apptoschea ❑ Cross Drain ❑ 3ize <br /> Attachment to new&oee PV Yee ❑ No A <br /> L HEADWALL: Yes ❑ No <br /> S.ASPHALT CONCRETE DUM: Yes ❑ No 1 , <br /> 6--BARREMS along Right-cf-Way <br /> 7. DITCH Yes <br /> ❑ No IfYes:• V Style ❑ 2 Poia ❑ Other <br /> pul� ❑ Wim Depth <br /> >>�>>""'""""'""', ">>>>>>>>>>>»>>'ERM:ITREQUIItEMENTS«««««««««««««««««««« <br /> 1, DEIVEWAY: SFR COMMERCIAL ❑ AGRtCULTUR$ ❑ INDUSTRIAL ❑ <br /> PAVED with �- "W,Depth A.C.over �" <br /> "Mm.Depth 3/4"A.B. <br /> Notes <br /> 2. PIPE& Leugth of Pipe R-pAv : It and Dianwbw of pipe Inch <br /> To be connected to anys4went drivewaS,pipe Yea ❑ No - <br /> DRAINAt3E INLET REQUIRED Yes ❑ No !' _ <br /> Tot41 Length. (withPr0P0Bed) <br /> Notes Totd Nreaber erStmrm Drat;!delta <br /> 3. HEADWALL Yes 0 No <br /> 4. PAVED FRONTAGE: PAVED with "Mm Depth AC.over <br /> "Min.Depth 3/4"A.B. <br /> Meng Feet in tmdh and Feat in width <br /> Driveway EnaoscJment Pamit basefee. FFM..............._...... a>;s <br /> eld Inspection <br /> eubriveway w/or w/o <br /> ❑Driveway w/box C�rlveat._..... _. ..... _..__...._....__.S1S3.00 ❑❑Paved <br /> ---- ----- +0.46/f <br /> SI0. +0. 88Cd,Gutta SidewaiL....._......_.._ 09 <br /> CaunterlComputa;c:lAccesslApplmation for PemitslDriyeway and Paved Frontage <br /> Page.2 oft Revised 8/Z000 <br /> `5 � <br />