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NV5 Daily and Staking Grade Sheet 2019-11-15 ADA Parking and SpandrelNV5, Inc. 42-829 Cook Street, Suite 104 Palm Desert, CA 92211 Tel: (760)341-3101 Fax: (760)169-4086 REQUEST FOR SURVEY STAKING Note: This form must be faxed to NV5's office a minimum of 48 hours in advance of requested staking to allow for office calculations. All work needed must be included in fax; if not included, client must not expect NV5 Survey Crews to commence work. *Information to be completed by NV5. All other information to be completed by client. REQUEST FROM: CO,M^PANY NAME: DATE: TIME: : *REQUEST RECEIVED BY: *JOB #: *DATE: *TIME: NAME: TYPE OF STAKING REQUESTED (CURBS, SLOPE SlAKINtr, �EWJr tc., E, I%,. - TO BE STAKED PER: DRAWING NO. C -4 SHEET NO. AREA TO BE STAKED (USE STATIONS IF APPLICABLE): tQI-A �_16 to � LATEST REVISION DATEIA OFFSET DISTANCE: ON WHICH SIDE? (Right or Left looking up station): SPECIFIC INSTRUCTION (Be specific — mark up and fax portions of plans for clarity): :. LE _A I * CONTRACT INFO: * IS WORK REQUESTED INCLUDED IN CONTRACT? YES NO DATE AND TIME REQUESTED FOR SURVEY CREW TO BEGIN WORK: DATE AND TIME SURVEYORS ARE ABLE TO SCHEDULE CREWS: (-\, - -), < � y --•----r ca�3rt5 231d1 i ap i l 12' 20' 12' ~— m a 3 Fs F5 N y. ` v) VAN S qP1+ '6 r 2 -`i r FG r! 0. 76% S 1 j 30. i_ RNAG r Old Ott 1N 1