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GRADING-INSPECTOR RECORD
<br />APPROVALS DATE COMMENTS Ovncr Blildd Ddl.6'ion
<br />I h.r.hy,mrn und.r r.Mlty o ap.rjury lhat I am ci.mDl f(trm lh. Conlra.loro' Lic.n* tow f.rih. foilowins r.!nn (s 7011.5 B8incrs
<br />.nd PNf6non Cod.) Any cdy.r counly wh'ch rcquire a Frmn l. onnrucl, alrd. inprok. demlhh or r.r'!n any srdcrurc. lfior r. irt
<br />hsuancc, oho requircs lh. arplicad for sch r.mir to filc . siSn.d {,l.m.d lhal ht or sh. B li..ns.d Nm,nr to rh. ,'m$tr,ns of rhe
<br />Conlmclf s Lrc.nsd Ltrw (Chlplcr 9. Com.tuF8 * hscri,n 7000ofDivkion I otlh.BlrinBsa.d Proa{{otrr Codcl.r lhal h.nr
<br />.h. ir.xanDt rh.r.fmm and rh. hdir fo. th. all.s.d cx.mFrion Anyvioldhonofselio.T0ll.5hyanyamlm foru lBnril suhj.crr rhc
<br />arnlic.trr ro a civil n mlty ot ret mr. thnn nv. iundred dollm (3500).
<br />l, .r ow..r of rhe pmp.dy. or rny .mplor.cs *irh wn!.s * rher $ l. compcnst ion, vill do Ih. *ork tnd ih. nrud !E R nor 'nr.nd.dor .lLftrl ftr sl. ( Se 7044, Busik$ and Pma.ssio.s (-ode I h. Coak*ttr s Lic.nE l-is'ItE mr dpply t' 0n o*m. .l rhc ,mFdy
<br />who l,n,ldr or m,pbnc. rh.rsn. rnd wh. dos flch *ork himFlfor h.Nltor rhmush hh or h.r os'n cmploycs, pmvidcn thlt rlr
<br />'hrr.v.m.nr3rr. mt inr.nd.i or ofI.r.d foreL lt how.v€r. llr huildins or mpmkn.m is eld q'nhn on r.6r ol.onrrlchon, th.
<br />ONn.FBund.raillhav.lheturdenofprolrnslh h. oBh. et build or inrrrerc for rh. Durl'oc.f sak).
<br />l. fls owner o I rhe nhn.ny, .m .rc lusiv.ly conk.crins w ith lic.nBl Nnrrach6 kt bnitrud rh. nrejal ( sd 7()4-4, 8urin.,< md
<br />Pmacssion Cod.:'l hc ConrEcroas Lic..s. tiw d.ca nor 0pnly ro .n os'ftr ofropcny who buildr or rmpmEs lher.on. rnd sho
<br />conf.cts lor such lmJ.ch *irhn conr.lcro(rl li.cndid Nminrro rh. commcrois Liccnk ljw )
<br />_l !n .r.hpt otd.r S&rion .a & P.c lor lhis rcosn
<br />!48IEES-CAUIETSAIION-AICIA8ArX]N
<br />I hcrc$y amrm lndcr p.Mhy of pd.,!ry.E o[rh. follosnS dehhrions:
<br />I ha\e md *ill fta'nlain . Cd ific,r. o I Co.sd io S.lf.l nsurc a.r qo.k.F coml.trsr on. I Dmvid.i aor hy sdrion I700 ol rlt
<br />L.hor Cod., for lhe nefomame ol rlE work for*hich rh.r.rmn h k.u.d.
<br />-l
<br />hovc.nd willnoinlDin workcB Nmp..slhn i.fldeq .3 ,.qutr.d by Sel ion 1700 of lh. L!b.r cod., aor lh. p.rfomnc. oa llE
<br />wort forwhich rh& pdmn ie is.d. My qorl.u emp.nsrhn in$6nc. cdid.nd Poli.y numlid e
<br />""",* '5,(r.1e F,rrJ
<br />tSLl | [50 - 20 \1 ot-6\-?or6
<br />(1 hh Kt ion E.d not b. .ooplct.d if lh. l.mi r nrr Oft hundEd dolhE ll 100 | or L$)
<br />I c.ilify lh.t in rh. p.rforMm. ot th. wort fo. vhich lhi. ,.mn i3 is.d. I sntll nd .noloy My ,.et in any n..*. so 3c ro
<br />h..dm. $bjer h rlE mrlcn ' onp..$l ion lawr olc.litooi.. ..d .8ft lhst if I sl$uld b.totu lubi*l to ih. wo*ss
<br />6aser io. 1700 ol
<br />'h.
<br />bh.r Cod.. I
<br />t rf
<br />wARNING l,iilur€ro wurc *ork.n comp.tudrion cokra4 rmlowful,andshallslhjs!an.nlloy.rrocrimin0lp.nollicraodcieil
<br />nn.s up to oR hudrcd rnousnd doll6r (t 100.000).in addn io. t rhc oi o f conlEnsarion. drn+e di ,mvdcd for th. S-l nn l(|76 o,
<br />rh. Labo, cod.. inr.rcsr lnd 6iiom.y . f.s.
<br />LICENSED CON IiAC1 OR-r DTCLARAI I(tN
<br />I h.eby {m.n utul.! t Mlry ol F.jury rhat I !m lic.nrcd !nd.r pbvhbn dtchapln 9 (mmncncirs wiih S.clio. 7lxr0) ol Divhi.. I ol
<br />rh.ousi*srafld Prcl4sions Cqle, sad ny I'c.dc n rn tull rot. .nd .ller.
<br />155f)9o 11f\'L G
<br />I r1
<br />qgliralglrax-Llxurc-{Gtlc.!
<br />I h.rhy,mm uodd Fuxy ofr.,jury rh.t ihc h ! codruclion l. tinsa8.dy for rh.I'dft,mN. of lh. qork tor whth rhi. p.mi ir
<br />is$.d (Se. ld)r, Civ. C.).
<br />AETLICANI.iDEqdAAIIQN
<br />D.mli{ion P.miri-a-th.rlG Notificdrior I.ddl R.8xrldrprs (f irk 40, Prn 6)
<br />R.quiEd L.ltr.f N6ti,icr!ion
<br />_l ceniay ih€r rh. f.d.El rcs(ldt ion! r.geding aibdror Emv.l 6.. mr amliehl. lo thir nmj.u.
<br />A I c.n'fr rh.r I hrv.6d rhFal,!lrcdor Dnd sidl. rhlr th. lhoc infom io. i3.oGr, I .8t* lo comnly *ilh all Ciry lnrt Counry
<br />ordrMrcF ad Std. Lam Elorms ro burldrng .onnrudDn, and h..cby 6ulhoriu r.pr*nlali!* olllit Caty ard Cou.ry ro.nr.r uFn rh.
<br />-')$lr lr
<br />Preliminary Soil Report
<br />Excavation
<br />Fills
<br />Sub Drains
<br />Buttresses
<br />Soils/Geology Report
<br />Statement of Compaction
<br />Compaction Report
<br />Flood Elevation Cert.
<br />Paving
<br />Sub Grade
<br />Aggregate Base
<br />Water Test & Seal Coat
<br />Asphalt Concrete
<br />Soils Eng. Cert
<br />Rough Grading Release
<br />Final Civil Cert.A
<br />FINAL \-+1-u q-\t\4.
<br />Notes, Remarks, Etc.
<br />-l
<br />ID/SIG.
<br />.trvc m.n"omd pmp.ny to, l}{('iotr rflrs r--,
<br />Aprricln,o,ascn,6is NLIUnT) lL: tS*
<br />,.*.* -*,n,,,) Kflr=che_a lpCte
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