HomeMy WebLinkAboutPD 02-02; GUSTAFSON RESIDENCE; Engineering Application•
- CITY CARLSBAD ENGINEERING DEPARTT. I
AppLIcATION..
ENGINEERING PLAN CHECK
Cornp!ete all appropriate information. Write N/A when not applicable.
PROJECT NAME: C—-j DATE: . -
PROJECT DESCRIPTION: A . .
PROJECT ADDRESS:ADDRESS: '33,4 -.-•— c r.
LOT NO(S).: c MAP NO.: _'-4_APN(S).: Zi 5 - '4 ? 3
NUMBER OF LOTS: I NUMBER OF ACRES:. *
OWNER: fr,.J - _i s.j APPLICANT:
Mailing Address: L _5_I Li , . __.. q Mailing Address:
_2L'47 l5
Phone Number: 71'4-2'$ _3(_ PhoneNumber:
Fax Number: ,4_ Fax Number:
,E-Mail: I' e..c I. _uts-Ps 4 E-Mail:
I certify that I am the legal owner and that all the above
information is true and correct to the best of my knowledge.
signature:kJj-_-.___._Date:t-3--O'- Signature: .Date:
CIVIL ENGINEER: PA _ ,t _ SOILS ENGINEER: 4Z-A Lp_
FIRM: cc—<,. FIRM: /'.OtC
Mailing Address: jg N-6c-' _Ai_Z3 Mailing Address:
)r4_3L!( CALcL.9
Phone Number: '?14-741-633-) Phone Number: 1 L -_7'3W...j2_ì4
Fax Number: ')i9 -11I-''3 Fax Number: (3_3q)
E-Mail: E-Mail:
State Registration Number: 39g_L State Registration Number:
ADDITIONAL COMMENTS:
IMPROVEMENT VALUATION
1. What water district is the proposed project located in? (check one)
fl Carlsbad Municipal Water District DOlivenhain, UVallecitos
2. If in the Carlsbad Municipal Water District, what is the total cost estimate, including the 15%
contingency fee, for water and reclaimed water improvements, sewer (for Carlsbad Municipal
Water District only), street, public (median) landscape and irrigation, and drainage improvements
(if applicable)? • $
GRADING QUANTITIES
cut 1 _Z-c Cy fill I '° cy remedial • cy import I)ô cy export cy
L Ic L
- .
SEE REVERSE SIDE
H:ilDEVL0PMNT SERVICESIMASTERS/Aoolicatlon for Enaineering Plan Check - Revised 1/14/02
M11
An employee-owned company
PROJECT REVIEW COMPLETION
The following project has been reviewed and are recommended for approval:
Project Name: Gustafson Residence
Project No. PD 02-02
Document No.: DWG 401
Sheets No.: Through: 3
DECLARATION OF RESPONSIBLE CHARGE
I hereby declare that I have exercised responsible charge over the review of this project
as defined in Section 6703 of the Business and Professions Code and have found the
project to be in substantial compliance with applicable codes and standards.
Review of this project does not relieve the Land Surveyor or Engineer of Work of the
responsibilities with state and local ordinances.
Cui Z~ No. C576
Exp-
OF
Signed cLJL L 5l— Date
Charles R. St. John, ROE C57649
Expiration Date 12/31/05
California 92024 • Telephone: 760.753.1120 • Fax: 760.753.0730 • www.pbsj.com