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Call <br /> nrfow <br /> °'" <br /> LOCATE REQUEST FORM <br /> Its smart. It's Free. ft's the Law. <br /> 1-800-892-0123 ULIE <br /> 1 COMPANY PHONE NUMBER WITH AREA CODE CALLER NAME <br /> Form is to be filled out by Landowner <br /> 2 COMPANY NAME <br /> 3 COMPANYADDRESS <br /> 4 CITY,STATE,ZIPCODE FAX NUMBER WITH AREA CODE <br /> 6 SITE CONTACT NAME PHONE NUMBER WITH AREA CODE EXTENSION(IF APPLIES) <br /> 6 COUNTY(MUST provide Ws inlolmlaion) Check one end fist Li VIULAGELJ CITY(URaw UNINCORPORATED TOWNSHIP(RURAL <br /> Macon locodon name <br /> 7 SUBDIVISION NAME r7579" <br /> ADDRESS OR LOT NUMBER <br /> 8 NEAREST CROSS STREET/CROSS ROAD,REGARDLESS OF SIZE,WITHIN A 1/4 MILE(Indicate street road lane,drive,avenue,eta) <br /> 9 The standard we accept Is Nath American Datum 83 LATITUDE LONGITUDE <br /> (NA063):format is degrees,minutes&seconds <br /> 10 JULIE Members and their subcontractors must TIER RANG SECTION QUARTER/SECTION <br /> provide On seetion-cluarteHssction Information. 16N 3E 16NW <br /> 11 ADDITIONAL LOCATION INFORMATION(Exampes:d mcw"wtanarb.cWaeoe from newest towns etc.) <br /> 12 <br /> 13 TYPE OF WORK(Examples:tnanan krssaw cabwebphone dmpe,/ens tva kwasat-peat rmes/ahnnbs.loundadan,d ft wall etc) <br /> Strembank Stabilization <br /> ARE YOU DIRECTIONAL BORING OR (Check one) LL YOU BE Of"GING DEEPER THAN 7 FEET? (Check one) <br /> 14 HORIZONTAL DIRECTIONAL DRILLING? ❑YES ❑ WI <br /> NO [I YES ❑NO C]UNSURE <br /> 16 EXTENT OF WORK(Examples:locate north side of building,along rear lc fine,front of property to curb,lot fine to lot fine,eta) <br /> 16 <br /> 17 EXCAVATION SITE OWNER OR RENTERS NAME pl otherdnen cased IS THE SITE PRE-MARKED? (Chock one) <br /> Will Good ❑YES ❑NO ❑UNSURE <br /> 18 NOTES TO UTILITIES ABOUT EXCAVATION SITE <br /> 19 <br /> 20 <br /> 21 START DATE AND TIME OF EXCAVATION(given to color by ope►ato0 IS THIS A JOINT MEET? (Check one) <br /> ❑YES ❑NO <br /> 22 DIG NUMBER(given to caller by operalar) KEEP YOUR DIG NUASER AS PROOF OF YOUR CALL TO JULIE <br /> AND AS A REFERENCE NUMIBER FOR THIS CALL. <br /> 23 DIG NUMBER ,VA OR X 55 5555 � <br /> EXPLANATION: JUUE system tolerance numbers Jusan Calendar OntoRequest sequence taartber for OW day <br /> JULIE MEMBER COMPANIES SENT THIS MESSAGE(giver to calor by operator) <br /> For your protection.JULIE recommends that you search the area for the facilities of others who are not JULIE members and notify them separately. <br /> In addition.you should communicate with the owner of the dig site to determine if there are any privately installed lines which are not marked by <br /> member utilities. <br /> Revised 6-2005 <br />