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MtNIMUM REQUIf2EMGNTS CHCCKLIST <br />RIGHT OF WAY US[ PERMIT <br />PLAN CHECI< NO. �/oZ� � <br />All applications to be completed in ink. No application will be revicwed until all <br />required information has bcen received, <br />1. Completcly iill out all 6lanks on Riglit-of-Way Usc Application, <br />2. If they have not already been provided� application will rcquire four (4) readable <br />copies of site pians� such as ENGIN[ERING DRAWINGS, drawn to scale and <br />sliowing: <br />a. Property lines <br />b. Outline and dimensions of existing and proposed structures on Public and <br />Private property� labeled existing or proposcd, and showing intended use <br />c. Existing and proposed utilities including poles, hydrants, etc. <br />d. Centcrline ot abutting Rights-of-lVay <br />e. Any topographic changes requiring cuts and fills, other than normal <br />foundation excavation <br />i. On-site drainage systems; wlien required or proposed, include calculations <br />g. North arrow <br />3. All submittals to be collated and folded. <br />4. 11 you have any yuestions concerning the requested information, please contact <br />the Public Works Department at 259-881 t. <br />ACCGPTED [3Y: <br />�y / <br />.--,.-�-z-� /_ �- <br />ame <br />, <br />/�ff�-�.-�� ��4i,i . <br />��11�C <br />.�� �� �so <br />atc <br />