HomeMy WebLinkAboutPE 2.11.17; ROYAL HOMES NO 7; Engineering ApplicationPERMIT NO./E
0 .1 ppl ication for Grading Permit 41 1 /I0/8C(It'ter codëE+.h'umbér)
CITY OF CARLSBAD Llot
PUBLIC WORKS & BUILDING DEPARTMENT S=subdivision
1200 Elm Avenue C=City contract
729-1181
FOR APPLICANT TO FILL IN
Site Address p J2SO
SuretY Bond Bond No.
Legal Description Map No.
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Su/ety Company
Subdivisi,p..1Jame
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Surety Address
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Date Filed Rec'd by
Owner
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ddress )wner
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,,, j 0 Cash deposit Rec'd by Date filed
$
P lans by Civil Enaineer R.C.E. j3 i7
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The following documents are required and shall
become a part of the grading permit when they
are approved.
./rading plans Specifications
L/Soil report Vicinity map
Drainage structures Retaining walls
Compaction report _Other
Address Phone
i244..Të. T (4ds.,,4b '2z'if'j'i
.E.j&3' Phone Songineer R.0
~SVCO I3 7/._3SO
Grading Contractor Phone
Address Check if supervised
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
arty res cxisible for overal I supervision )LC I. Authorized hours of operation: 7:00 AM to
roposed use of grade site
t-o-i,trc
5:00 PM, Monday-Friday.
Haul routes are to be approved by City
Number of cubic yards
Cut Fill Import Waste
Engineer.
Adequate provisions shall be made for
erosion and siltation control.
All slopes shall be planted per direction
of Parks & Recreation Director. Total /
Compacted fi I Is (yes or no)
Proposed Schedule of Start Finish
Operations (dates)
I hereby acknowledge that I have read the applica-
tion and state that the information I have providec
is correct and agree to comply with all City
ordinances and State laws regulating excavating anc
grading, and the provisions and conditions of any
permit issued pursuant to INis
Signature of
Owner or authorized agent
INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
- Rough grading
Compaction report rec'd.
Planting & drainage
Final certification rec'd.
Grading permit fee $ Work completed
Surety bond released
Permit Validation I
by ./-Z-.6-c/ 1&22~ Date -
Permit Expiration Date
THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD .4