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'. <br />Expense Job -Site Information (for non-estimated work) <br />PM #42.5"LJ•....'1<LJ~Q~----- <br />Name &Lan ID:.G-t.!S lie'Z.cdde.cJos C rIIV7 <br />Address:~0 (,ho cro.:WP <br />City or County name:_D•..•...r/'l.'-''''c j------- <br />CPA:-3 )7/-I <br />CPAmap attached?0 YES 0 NO <br />Description of work needed::r:rVS 10../1 .5 -{;l lb a..rJcJd eS Q rJ G-t<.S fl1o,,;!1J <br />;61 If'X8'[]e,Ube.le @.9/02.L.(lf(a:~le <br />Work location Sketch <br />J .•.•1(\V.I.', <br />I 3 <br />f\J 'I »-r-I !1 <br />E.D I <br />~I' <br />~orro.i /\;Ie M I R <br />Cc i'I---J:~;-'-~--'----..•._-- <br />I J.'--'i'I~'Ill' <br />~Jcop ~~t1'-~_"A"'.'I1)-L-,.,I <br />I <br />qlOz.I <br />Excavation Location Sketch Requirements: <br />1.Providedimension from cross street 1and crossstreet 2 <br />2.Dimensionshould reference as back of walk,edge of pavement or center line <br />3,Indicate North Arrow