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ASPHALT & CONCRETE BUY KNOX,., INC. <br /> NAME -�-"` CALL SACK____ <br /> WORKSHEET NO YES # e�i <br /> DAVE +►I• <br /> TREE STUMPS ❑ GR ADDRESS <br /> TREE ROOTS ❑ 2 <br /> SPRINKL NG SYSTEM ❑ Cl ZIP <br /> P43NE WIRES ❑ � __--�.--_ <br /> ELECTRIC WIRES 13 HOME PHONE DAY PHONE <br /> CABLE ❑ 3Y d qg sw,) <br /> WATER SHUT OFF ❑ APPOINTMENT LEAD SOURCE DATE SOLD <br /> CONCRETE ❑ - •'" ------- — -------_ <br /> DRAINAGE PROBLEMS Cl _ <br /> GRADE CHANGE ❑ c TIME <br /> HEAVING ❑ LEAD <br /> OVERHEAD L NES ❑ ----------- <br /> TREE LIMBS . ❑ APPOINTMENT SALESPERSON <br /> ROOF OVERHANG � ❑ 1 CIRCLE <br /> MAP CO-OD <br /> GAS LINE c ❑. TIME <br /> SAW CUT AT STREET ❑ PROP. DIS. AP GR(9&SP PT WL <br /> EXCAVATE <br /> r ■ • • . S C H E D U L E R P G C P Li <br /> I <br /> VASE / ■ ■ f / r r <br /> C O M M E N T S <br /> i <br /> EC <br /> MACK <br /> HAMMERD - <br /> EXTRA ' <br /> TRI.JW WT ■ r <br /> SAW CUT ■ <br /> EXTRA TRK ■LOADS N ALI <br /> 1- <br /> CLAY <br /> BARRIER a 'I <br /> 4c, <br /> REPLACE <br /> WITH _ Do <br /> a 0 8 4 6 0 S/ 6 ' . <br /> °►/C <br /> -- ` <br /> ACCT.PROT. ■ CREW: <br /> C ---------- <br /> - a------------- <br /> Sqlio7 Cies 740 Mee <br /> v SEAL. • ■ ■ • ■ • •s s <br /> ke"v c(of■ ■ de ■ f • ■ <br /> KEYSTONE - �' ■ ' <br /> TIMBERS <br /> r <br /> -- CUSTOMER TO ADJUST SUR- <br /> ROUNDING HEIGHTS TO MATCH <br /> FINISHED EDGES AS DEWED ' <br /> regarding this installation is everything you wanted in writing? We have received your installation booklet Customer agrees to pay any require permit fees ❑YES F7 <br /> inlllai <br /> y`� n n TM 7?T CI TTM m�rtrn T'4 V W �L rn nM WT'N �s T ry TTATnv -__ <br />