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253225 site plan.pdf
COOM03 � CSG Locate#:��3a�� CSG Qrap Bury#:�_.� Date 1� ! ode: l:�l Bury woo corm " Customer Name. �(�5�}tn Rosen Phone# : �'r„� ,� Zip:q 0 Cross Street: I Address: c► ✓V- ": '-ity' QService Effecting ❑Out of Service []Pending install rgTemped Tech# 800q Tech Cell: '4�$-3Q�-aa1:5 Priority Level,- cial Lj2-New Cust /Svc prop Impalred /Can't Temp E]B Svc Qrap impaired f Can Temp ment: Y]N® Type of Bury: STH Footage ROW footage Permit Required: Y� Nn Back y N11 Sidewalk Bare Planting StripYarYard I aseSystem:: Y] N�Sprinkler Septic Field: i sidewalk: y[] N p Driveway Bore Y N[[ i andscape Bore Road Edge: YQ N�C Drain Pipe: -- -- --- � � CtlrE�: Y N[] Private Water: Y[] N Road pore y - NN SoftsuYface ( / Hard Surface Total: 1 PrnraieWiring: Total: 41" Total: 5 �� Total Bury: C What Kind? Customer Home For Bury: Y[-]N Call customer First: Y N[] Best # For Customer; (j C�rnlnerEts (I C' � Om � ' CUSTOMER CONTACTED AND REVIEWED ROUTING OF NEW DROP Y� NOT HOME, LEFT DOOR TAG yu Boirtg the awner of the abave property, I hereby give my permission to Comcast, ortheir duly authorized representative to bury a service line on my property. Property Owner's Signature; �--�— a.ezend p Poll- Phone- SireetLight.0 ffl 7V - Existing Carson -A Places Carson - A � lVlail BOX - Power- Fire hydrant- 0 waterjlrrigation- P©wer- Catch Basin- Qas- ETC Shaw Center pine to: Curb 5idewaSk Ped iC 51)a�r -s 'ns— a Area's: Wetlands creeks aar Ditch H! h Point i.ow PED�t ITENfS EST W ACT QTY I EST Q`!'3f ACT QT`� Iv1ATI EST ACT i MACS r� tJ / fir^ I9 1'� 21, i1MIRK momm MW -46 al;07 .