Laserfiche WebLink
I- i uati uarssuo oras,cru au um pruvlmm cx oras 8PP008UM am that thedesmptioninckWed inthis apphcaetion are cm eot to tAa bast of his/her <br /> knowlwdge;and <br /> 2. That hdshe is the owhher ofthe reapectiva propedy,or is qualifiedto tgxrsent thaowhxa;and <br /> 3..That he/she will sesame fait ceapoudlility for ail fidxTity furporsonai injury ordamage to property which nary arise oat ofthe work described above, <br /> or whichrosy arise out ofhis&ar Wkwe to do the watkpmvided herein;and <br /> 4. That in the event any claim of such HabMy is made Against ttwComrty of Sao 3oagium or any dam,officid or employee them be shall <br /> defend,indemnitor and holdthaat and each of them hah�for such chhimG and <br /> S. That work shall be pedormod by the anhcv t and/or any r0WftwtxfiVe of the applicant in the Cm*Right-ofat the abova indicated site <br /> wlth a valid San Joaquin Counly FAcroadmat permit;and <br /> b. That if perp ishdon is granted as requested,he agarose to do the work described in aoomhwe wia an tehma,000ditiew and restriction of this and any <br /> attached sheet,ihlcdttded as genarai or special Iii pto�iaians. <br /> sigoetmUtliana-Tate Date <br /> FIELD INSPECTOR(7OADUMS <br /> »»»»»»»»»»»»»»»»»»»> <br /> EXISTING CONDMOM«««««««««««««««««««« <br /> L DRIVEWAY: Nene Dirt } <br /> ❑ Otavel ❑ AgD»gskeBase. Q ) ❑ p-o'kGood) ❑ <br /> 2. SLOPING: APW, Nvaad ❑ Tomw&Pavement •El Fig Ap ) <br /> 3. Pvz&-. NOW j� m <br /> Ex6Eing-Type <br /> Othor pipos in othood: Yes ❑ No Approaches Q Cross Drain ❑ Sim <br /> Aitadanaot to naiglabals pips Yes ❑ No <br /> 4.HEADWALL: Yes ❑ No, <br /> S.118P1#ALT CONCRETE DIICl4e Yes ❑ Na <br /> &.BARRMS alongBig"Way <br /> y. D1TCS Yes ❑ No IfYas: V Style E] 2 Point E] Other ❑ W dth Depth <br /> PERMT REQUIItE1dENTs««««««««««««««««z«««< <br /> 1.DRIVEWAY: SFR Ai COMMERCIAL ❑ A(GRfCMT'DptV, ❑ INDUSTRIAL ❑ <br /> PAVED with "Iso,Doh AC.over 4 Adm.Depth 3/4"AD. <br /> Notes <br /> 2. PIPE& L x*ofPipeRequired: Pt,andDimim rofPipe Inch <br /> To be connected to any adjaoeot driveway pipe Yes ❑ N <br /> DRAMAGE INLET REQUMD Yes No [L7� <br /> row (vft P vPON* Tober of Stom Dsaht bleb <br /> Notes <br /> 3. HEADWALL Yes ® No <br /> 4. PAVED FRONT <br /> AICfE: PAVED with "Mm,Depth AG over "IVfm.Depth 3/4"AB <br /> Feet in leug&and Feet in width <br /> FM <br /> Driveway En"owhmaal Permit base fm......... . . ...... . S85. <br /> Field Inspection <br /> Driveway w/of w/o pipe....... ____ 595. ❑Paved ftx> age _. _ . __ ..__ SIf)0 00+0.46d <br /> ❑Curk Gutter,SWowaar...: .....:........._$100.00+0.98/$ <br /> CountalComputer,C:1Aoo=VPpliaati0n for PecmWDriwmy and Paved Frontage Page.2.of 2 <br /> Revised 8/2000. <br />