site plan 108622795[15IQrk Description �'L C
Construction 1(etfnad
•
Open Trench [J
Rev. 11une 7, 2013Job
TRE -INSPECTION FOR
FORM
Trenchless ❑
{ I
TTr I { I ( { —ii T-1— i.I
I f i! i!! i(
Bate:=[Address:
qL
Il llilillil[ ii[,`.,-
Jurisdiction:
r 1 I f
City{/ zip:` Valm
I I I 11 I i I f f I I
`• FSt. Start Date:
Customer:
Est Duratio n=.
-
PM / Jnsp: f/10aCU-
r,[15IaMEftPHONflkuNl�Erz -
.
PHOMEIgUMaEK -
I I;I 1 (Till
IIIi f1i(11
11{f {I €1'I
1111€11 IMiI i liiil(i
;ii[111 f llllllfll
ilLfilI[==l
1_j l T - F-1
[15IQrk Description �'L C
Construction 1(etfnad
•
Open Trench [J
Trenchless ❑
{ I
TTr I { I ( { —ii T-1— i.I
I f i! i!! i(
iIl!11 f i1=!I
€1!1111!
Il llilillil[ ii[,`.,-
r 1 I f
I f! 1 I I f{ {' € I I i
I I I 11 I i I f f I I
I I f 'r l
I I;I 1 (Till
IIIi f1i(11
11{f {I €1'I
1111€11 IMiI i liiil(i
;ii[111 f llllllfll
ilLfilI[==l
1_j l T - F-1
1TI 1 I I 1
i I 1 11� I► I
i 1. 1' (T3 i I`-- 1 -sem I I t :' i ! 1
i_!6?+ i
f?( f l I I I I. I I
I I i f I I I f'
I f 1 1 1 f I! J l l
I l f 1 1! :Ili i I f I 1 I f l l
l( 1 T17 I I I I I 1 1 1
I 1 1 1! € I I I i I1 1 1 i t l
• I__�___' 1- I {
[-�.
�' Il
I�
1�� •1
1—i I I ( I 1—
I I 1 1_1
�T'- I �;•
i
1�__1_[�I_ I�i _ I i I�
1 1 1 1 1 1-._�i��`--_-;-, r�. -::_
-l_I -1 I F
TE: 177 t I- I r I-1- l
€ I z
_1 -� -� -I 1
'~•s i 1- i! i
L IN !A'.
Work Locaiiart _ Size. o -F Cut � ur-dace Ty� �
'N S oT CL, & 'E W of CL
--�NSofCL & 'FWofCL .
Flag ers a` ___, Police Flaggers Trolley Unes ❑ Bus Stop ❑ # {Meter Hoods [I #
speed limit mph ❑ �. Traffic signal ll - .Arterial a No Parks ❑ ft
Commercial C Altered Commercial L] teak Repair ❑ Service Information Bollards 02..5114f7#
Residential ❑ Altered Residential E] CP Work Q Dhrmeter Nfeter EFV Template. Bar El
Multi-Fam'11Y❑ Replace mentService❑ Pothole E] 5/8" ❑250 01.800 ❑ Fuel line PermftQ
Neve Service ❑ iVJain Malntehalice [Extension_ Q x �%8" Q 4z5 ❑ 2600 Ci Fuel Line Len�h,_____
stub Service MaintenanceEl Complete 11/411 E '630 ❑ 7 0,p00D Fuel Line ❑iam.
Cut & Cap C Valva Maintenar[ce ❑ Service 0 2 ❑. JOOQ0 Meter Location