HomeMy WebLinkAboutADJ 487; JOHNSON BROCCATO; Engineering ApplicationCITY OFeRLSBAD -ENGINEERING .ARTMENT
APPLICATION
FOR ENGINEERING PLANCHECK OR PROCESSING
. Complete all appropriate information Write N/A when not applicable
PROJECTNAME:. ________________________ _ DATE: e -(0-Cf (p
PROJECT DESCRIPTION: t:cu~ DAt2-'-"'\ A-OJ V?TMe1\
J
PROJECT ADDRESS: ~Ql ~60N fA CctJ(L( CA~(/:?~ ~V
LOT NO(S).: t,oT I'? '3 or M~fp Jb~ :;;"J ~ 1'2. of" IZ'lDtpN(S)~?>'l 0-1 e . 'Z ,,,. 450 _~
OWNER: ,.., K. JOt!t...\~N APPLICANT: SANE I-\~ ~ \~~
Mailing Address: 'f'2.-r b&Go~ IA C?U~-r Mailing Address:
cA fZ..(; I? f::A 1) cA 4 '2.00 9
Phone Number: {(O(9):4 ~ l-50Cf-, Phone Number: J...( __ ...L) __________ _
I certify that I am the legal owner and that all the above information
is true and correct to ~best of my knowledge.
Signature 1lA~'f"~ ~ Date __ _
f)tppM GoN~I.:{~lSA6 ~Nr
CIVIL ENGINEER: Th~ICI<::' tJ. O'~
Firm: d~vt CON.?Jl... TA,..l~
Mailing Address: 722..0 ~ V€"f-lI'DA ESNC!1-.lA:::>
~AlLS~ cPo. 4'2.co5
Phone Number: ( (PI j ) q~\-170f;:::)
State Registration Number: _---.:;;.2_7.;..2.=.,:1_4-=--_____ _
LANDSCAPE ARCHITECT: __ N'---L' 1_' A ___ _
Firm:
Mailing Address:
Phone Number: ..... ( ___ ...L) ________ ___
State Registration Number: __________ _
I certify that I am the agent of the legal owner and that all information on
this sheet is true and correct to the best of my knowledge.
Signature Date. ____ _
SOILS ENGINEER: ~ J.A. --~~,~--~~~~------
Firm:
Mailing Address:
Phone Number: ..... ( __ -1.)_---'-_________ _
State Registration Number: ___ ..,.--__________ _
ADDITIONAL COMMENTS: _________ _
NO. OF DWELLING UNITS: __ LFMP ZONE: ___ _ NO. OF LOTS:, ___ _ NO. OF ACRES: __
IMPROVEME~Ti ~tt~~~l?~;;r~:rer, water & reclaimed water: __ U-I/,-A.-.;... __
".'.' .• 1 'j.~, .. _,\_L,.;
Water District (circle one): Carlsbad Municipal Water District Olivenhain Vallecitos
streets and dnii~age:~\ I ;',1! ,:~I A landscape: __ .. _i-J....I(i-!· A~ ___ _
GRADING QUA~~m~?jj ~;tJ1;'A CY cut _____ cy fill _______ cy
'>-;:if,!;"i i::jAQ3C1 remedial cy import/exp0.rt cy
PLEASE CHECK OFF APPLICATION TYPES ON REVERSE SIDE
P:\DOCS\MISFORMS\FRM00063 REV 04/28/95
APPLICATION FOR
(CHECK ALL THAT APPLy):
~djUstment Plat
D Certificate of Compliance
D Dedication of Easement
Type: _________ _
Type:
o Encroach. i 11::1 IL Permit
D Eno' ICCI 11..4 Standards Variance
o Final Map
Ck3r::ld~; 11..4 Plancheck
o Gradino
D I '11 orovement Plancheck
o Landscan~ Plancheck
D '"'1:::1.1 vI::I Map
o Quitclaim of Easement
o Reversion to Acreage
:FOR
:Plancheck Type
'Number
4-rit ADJP
coc
DOE
" " . ' .. ,'.: ...
:" .: .... : ... : .... : ....... .
....... ::',,:,: .
. .': " .:RTA.· ..
..... : ... '.".::.,
D Street Vacation .' ':. . 'STY .' ..
o Tentative Parcel Map
o Certificate of Correction CCOR
D Covenant for Easement COVE'
o Substantial Conformance Exhibit see
APPLICATION.ACCEPTEO:.BY_. _______ _
:'MASTERPROJECT ID __________ _
RECEIPT:NUMBER,_' ___ '_' ______ _
. .pRELIMINARY SIERRA SYSTEM: INPUT lNITIAL. __ _
:·-SlERRA·:SYSTEM·INPUTfNITIAL ________ _
. RiBASE:.INPUT INITIAL. _____ _
" :. '"',
:,M~STER.FILE NUMBER: ·.:,...F ____ _
I::rnh~'r' :.:" .. ' .' . .... . ...... . .:. --. ,----------------,,::
P:\DOCS\MISFORMS\FRMOO063
ONLY
Drawing
Number
Project Deposit/Fees
ID. Paid
4&-; 1r3 ~l) c:l.~
..... "
. .': ....... .
" ,',
RECEI%~D'
AUG 1 It 1996
ENGINeERINC,
DEPARTMENT
.,' .. :' ..
DATE STAMP
APPLICATION RECEIVED
\
REV 04/28/95