Site plan 109131962Rev. IJune 7, 2013 PP -i 6P cTloN FORM f"Y
Job M 10915/9(a
Date: �a ^ f Address: D1 kJl 21
Jurisdiction, city / Zip.`
Est. Start Date; Customer.
3/,l ,� LI hIEA PHCINE HUMBER -
1=st. Duration: ' •��Yd—U PNi / fnsp: ,�' -
P—Ham 0 Ro
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Work LoGatipQ
Size. of C t Surface Tyne
l -f N of CL & do W Of
'N()of CL & 3 '11 of aka duJu�rl�
S Sri. a
'Nof CLW_
Flaggers J�!J—# �.._, Police F3aggers Trolley Lines ❑
Bus SLOP " ❑ # Meter Hoods]] #
Speed Limit mph El # Traffic Signal Q
.Arterial C No Parks o #
commercial Altered Commercial ❑ Leak Repair Q
Service information Bollards EJ2,5T 14 �_
Residential ❑ Altered Residential [( CP Work ❑
Dicimefer Meter FFV Template Bar d
multi--ramily❑ServfceEl Pothole El
5/8"
M 250 X800 F] Fuel Line PerrnitQ
'Replacement
New Service El Main Maintehance [I Extension_ El11/S"
x'425 [12 600 '. Fuel Line Length
stub OService Maintenance[j Complete
11/4"
❑ 630 ❑ 10,0001] Fuel Line Diam,
Cut &Cap 0 Valve MaIntenarice [) -service 0
2
❑.1000ED Meter Location- .