| Name: | Rod Rozman | Phone: | 530-621-4885 |
| Email: | rodrrozman@hotmail.com | Address: | 2671, Countryside Dr, Placerville, 95667 |
| APN: | 317300003000 | Nearest Cross Street: | Countryside Ct |
| Owner of Property: | Yes | Number of Piles: | 2 |
| Pile Size in Feet: | Total width :8, Total length :60, Total height :7 | Material location: | Shoulder of Road |
| Alternative disposition of material: | Burn it | How material was cut and stacked: | I cut and stacked the material myself |
| Number of hours required to do the job: | 4 | Hired someone, how much did it cost: | |
| Applicant agreed to waiver: | yes |
Service Instance | | | |
| Contractor Name: | Admin | Date Serviced (mm/dd/yyyy): | 06/16/2019 |
| Travel Time (in minutes): | 45 | Chipping Time (in minutes): | 122 |
| Actual Pile Size (in feet) | | Total Pile Width: | 10 |
| Total Pile Length: | 80 | Total Pile Height: | 6 |
| Supervisor: | David Justice Sr | Crew ID : | 18007 |
