HomeMy WebLinkAbout1594 MARBRISA CIR; ; CBC2022-0277; Recycle{"Cityof
Carlsbad
CONSTRUCTION WASTE Development S~rvices
Building Division
1635 Faraday Avenue MANAGEMENT PLAN
8-59 RECE\VED
442-339-2719
www.carlsbadca.gov
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APPLICABLE TO NEW CONSTRUCTION, All RES IDENTIAL 1 00 TION PA1r--J0 ALTERATIONS AND
CO MMERCIAL ADDITIONS AND ALTERATIONS OVER $2(}0g Y l~rou,have '.questions about the recycling
requirement or completing this form, please contact Republic b~ i'tes at (760) 332-6464 a certified C&D
recycler, or the Carlsbad Building Division at (442) 339-2700. Please note: Unless you are self-hauling, Republic
Services or approved haulers must be used for all construction projects within the City of Carlsbad.
PART 1 Complete and submit this form when applying for a Building Permit. Note: Permits will not be issued
without a completed Construction Waste Management Plan.
Applicant Information
Permit No. Project Title &,~< 8.Lb_WJ,., I. TL
Project Address_LS 'i Y /IU/.i,_/J_/l4 Sil c~ APN 2U-lJo-0-Z
Applicant Name ---:J'AutNT fl,.~
Last First
Applicant Address ~i'\O N. \.lAa.t\o«... Dk J
Phone ( 8$t, l::7J(, -\S 0'3 E-mail Address
Applicant Mailing Address
(if different than project address)
Owner Contractor
i?Jt
Other □ □ □
S:tc u,,
d0v~atJ..A,'°.V\C,,U>~
(check all that apply): D
:,.-
j oS
Project Type Re□sidential Colm7Jial Public Building In~ Jl·
Brief Description _l-'~~:I~o~-u~~~~~6~~0_,·1-...... F~\~c.6~ __ $_1>_~~a~~-------------
Project Size 3 19 I 1 5 ,'f-•
(square footage)
Please check the appropriate box:
Estimated Cost of Project$ ________________ _
121
□
□
I plan on using REPUBLI C SERVICES roll-off bin(s) for all materials and will provide all receipts after construction.
I plan on self-hauling to a certified recycling facility and will provide all receipts after construction.
This is a proposed LEED certified project and I plan on separating materials on site in conjunction with REPUBLIC
SERVCES.
Acknowledgement: I certify under penalty of perjury under the laws of the State of California that the information
provided in and with this form pertains to construction and demolition debris generated only from the project listed
in PART 1, that I have reviewed the accuracy of the information, and that the information is true and correct to the
best of my knowledge and belief.
Print Name ~N ~N7 Slgnatu,~ Date
Page 1 of 3 Rev. 05122
PART 1 Complete, obtain signature, and submit this form when applying for a Building Permit. Note: Permits will
(cont'd) not be issued without a completed Construction Waste Management Plan.
DEBRIS RECYCLING ESTIMATE:
•• 1.~-· Permit No. Project Title
Project Address APN
Applicant Name Phone ( )
Last First
• : Complete the following table with estimated waste tonnage to be generated by your project .
This is your plan for construction waste management. Changes can be made on the final recycle report.
Goal: the diversion rate shall be 65% by weights of debris.
A B C
Material Type Estimated Place a (0) check Place a (0) check next Place a (0) check next
Waste Quantity next to items to be to items to be to item s to be
(tons) reused or salvaged recycled disposed at landfill
Complete this line of the table only if
only using WASTE MANAGEMENT
roll-oft bins.
MiKed C&D Debris I l:) □ □ rt
Asphalt & Concrete □ □ □
Brick/ Masonry/ Tile □ □ □
MiKed Inert Debris □ □ □
Cabinets, Doors, Fixtures, □ □ □ Windows (circle all that apply)
Carpet □ □ □
Carpet Padding / Foam □ n n
Cardboard □ □ □
Ceiling Tile (acoustic) □ □ □
Drywall (used, new, scrap) □ n □
Landscape Debris (brush, trees, □ stumps, etc.) No dirt. □ □
Unpainted Wood & Pallets □ □ □
Roofing Materials □ □ □
Scrap Metal □ □ □
Stucco n n n
Other: --□ □ □
TOTAL --
..,-,"•lleJ,,■
To meet 65% Diversion Requ irement (estimate) X 0.65 = tons
Toto/ Estimated Waste from above Minimum Required Diversion
Contractor/Owner Signature Date
Page 2 of 4 Rev. 05122