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GRADING-INSPECTOR RECORD
<br />APPROVALS DATE,I 'lDlsrc COMMENTS
<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 />regate Base
<br />Water Test & Seal Coat
<br />Asphalt Concrete
<br />Soils Eng. Cert
<br />Rough Grading Release
<br />Final Civil Cert.
<br />FINAL
<br />Notes, Remarks, Etc.
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<br />O*mrSurld.r DNlarlnon
<br />I hcrcby amrm und.r p.nlltyolrcrj!ryrhd! I am.r.no form th.CofllEcroB Li*nr.L.w for lht hlLw in! ..i$i {K.7011.5 Busin.rs}
<br />a l Pmf.rsio. Codcl Any Cny or Cou.ty *hich Equn r r r.mil io oN'rud. ahcr, imrnv.. d.mlish or rq'ar int d tu.rur.. nmr h r
<br />h.m..rhor.qui€ h.rrplicanrlorsuchp.rmntonl..sign.dsbroh.ntrhnth.orsh.hlic.n8dpumanltothcDt'vhr.s.frhe
<br />c6nrrocror\ Lr.n*d Lls lclFpr:r 9. Co,@ft'ne enh sdri.n 7000 olDirision I of rh. aurinsi i.d Pmfdsiotrs Cddc) 6r rhir h. or
<br />!h€ie.xcmplth.refromandthchasirforrhcallcs.dcremrtionAnyviollrionofS$l6nT0.ll5byanyrppli..nrfor0pcmritsubjcclilhq
<br />nptlrcam ro ! civillcdllyof mr @Erh.n fivc hundr.d lollan ($tl[)
<br />_ I. 5i own r .l lh. pmp.iy. or ny .mrlolB with *.!.i rr rh.n m b dmp.nsr io'! -ill do rh. wort .d th. slrudr ii nol int.nd.d
<br />.r olT.Ed for BL ( s(.?(x4, BNiE! .nd Pol.$io.! cod.r 'l'h. cof,hcrol. Lic.N. L.s dfts mr apply ro u ow of lh. r,bp<ny
<br />wh. btrildr o, ioprcve thcm.. and who do.r tuh wo* hiself o. h@lf .r through fik or lEr oM .hnlorci. ,olid.d lhll tuch
<br />ispov.m.nN e mr ilt.ntu or olfd.d tor ek. If. lbw.vr. dk building or improwD.nl i. $U *ilhin om ,@ of coq)l.rion, rhc
<br />OwFBuildcr will h.v. rn bldcn of pmvins ln.r h. or sh. nor brild or impor for th. Durllor of sl.).
<br />-1.
<br />I owB! ofrh. Drp.ny, ao qclBiv.ly 6trl6di!8 wilh li..d.d mntractos lo onsltu.t ttE Foj.{t ( Sc 7044. BEi..s tnd
<br />Pofc$ion cod.: 'Ib. co acror'3 Li6@ Lrw dod mr.prly ro e oxE oltop.ny *ho hildr M idprck ths6.. rd,ho
<br />onr!.rr for Nch poi(k vith 3 coordcro(8) lico*d potu ro rh. c.orddoar Li..e Lrv )
<br />I m.r.mpr undq S<ion .B &PC t6. rhii rca$..
<br />Dal.r Owrl
<br />woR|(ffls contPfNsArtoN DICL R TIoN
<br />I hd.by afiim u.d.r p.nrhy of n rjury oR ofrh. following d..lahlhNl
<br />I h!v. and will miinrain ! Ccrrificor. .tcotrqd l. S.lf-ltrsr. for $ortc6 ..d!.dqriol\ { pmvid.d ftr by Sd i.n ] 700 of lnc
<br />tibor Cod., for rh. ptrlomrm. of lhc wort for whicn $. p.rDn is hs.d.
<br />tbll Mvc an<! *ill maiilain sork.rc' omrctretion insuBncc, Aa Eqoirdbys..tionrT00.rth. bbor codq ror lhc n..fnronc. ol rlE
<br />w.* for *hich lhiF pemir is iss!.d Myworkd @mp.n*rion inslffic crnid and r.ncy Nnb.r rrc:
<br />c*i., ' iJtf, Go*{z-{>,D*LNC- 403454
<br />(l'hir wrion B.d mt b. compl.rcd ifrh. Frmir is for Orc hud..d dollaF l:il00l or l.s)
<br />! ccniry dut i. fi. l.rfomr. of rhc wo.k hr ehiclt rhtu pmn i! irs.il I dall mr .rploy .ny p.Nn in .n, m.ntr $ s lo
<br />1,..!n. suhjer to th. m .B e,\Ersrion lam olcrlifomi.. rnd aB@ rh.r ifl ould b..om bl6r ro rh.w.rkcu
<br />comDcNiDn pDviront of Sd En
<br />^,,,9/q / t(l70o ollhc La66rcod..l rh.ll. t dh*trh comrly wnh rho* pmvtuio.s.
<br />or,r*,,/- -f) -'L--,..?tl , /-WAI{NINC l'ar.uri to Kure w.A.n mmn.ncauon cov.mx. ^ unlaw,ul, ind shxll {nrd ti .nnl.F ro mm'ntl n Mh rF dnd cN J
<br />finB u! ro.mtund..d thousnd dollm (S100,0m),in addilion ro th..oc of.omp.nslion, dlmrs s nmlidcd lor ri. s(rdn 1076 ol
<br />rh! L6hor Cod., int.Ht and axomcy s f.q.
<br />LIC}:IS}:DCONIBACIOAI.I|ICId8AIIo!Ih.r.hyaftiflDund.rp.uhyofp.dury'h l o l,c.ns.d u.d.r fsrFion ofChartd 9(om..cins wilh Setnn 700{)ofDnrrion I ol
<br />thc Ausimss a.d PrcferioN Cod., ard my liccn* ie in nrll forcc.nd crfdl
<br />Z a-4
<br />.24-L-
<br />coNsr I.t,( r()N r r:Nr)lN(: a(;t-l\ic\
<br />I h.rcby amro undd p.Mhy 6f pdju.y rn't th.E i. . onltoclion knding .8.my lbr lh. Fr6mnc. of lh. qork for which rhis I'crnil ii
<br />issucd (Sd 309r, Civ. C.).
<br />At&lca!.fsjl[claEauoN
<br />D.mltridn Pdoirr Ar$.sbs Notific0rio. I,.d.hl R.gtrlmia.r (1irl. 40. Pd 6)
<br />R.qun.d Lctt.r of Nolifi calion
<br />I c.nrfyrhrrrh. tcd.dl r.$l.rioni rgadins Nhrlm..m$1.r. mr aml'cahl.r. rh6 p(Fr
<br />ar-*nrr ,n, , n*. ,*n ,ni. 6p|li.ar nn rnd n.l. rhar rh. ah.k rndm$r ion is cord!. I a!rc. ro comply w h all crry snd (nunr,
<br />ordiMnccaondSrarcLou'rrcl.tinsrobuildinscoNtrucrbn.0.dhs.hyauthoru.r.rrcFnrariv.sofrhisC y and Counry ro ..rd ul$n rh.
<br />arsr mcntion.d pmn ny for ins,ction nrrrord.,^.,'*/a / t,77
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<br />Sub Grade
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