HomeMy WebLinkAboutPE 2.11.26; LA COSTA MEADOWS UNIT 4 LOT 696; Engineering Application/0b4t PERMIT
Application for Grading Per (letter code + number)
CITY OF CARLSBAD LIot
PUBLIC.WORKS & BUILDING DEPARTMENT S=subdivision
1200 Elm Avenue C=CItyot
729-1181
FOR APPLICANT TO FILL IN nnnf.l.nl -,
Site Address
1A(P_?4Lo..JIA-
Surety Bond Bod No'
Legal Description Map No. Surety Company
Subdivision Name
Lc C - Uiity 40-t_
Surety Address
Owner LV('.A
G
Phone
1ST -
Date Filed Rec'd by
)wner'sddress
t1 iI1 4-.U)( JP
Cash deposit Rec'd by Date filed
$
A -r7rcrSt,.Ic C?$(7
The following documents are required and shal
become a part of the grading permit when they
are approved.
Grading plans _Specifications
Soil report Vicinity map
Drainage structures Retaining walls
Compaction report Other
ddre Phone
) I' 1-V,z4' LA_Jj r
Soil Engineçr R.C.E. Phone 4c-4 \Jr4zj4o11 L-UZ-
Grading Contractor Phone
Address Check if supervised
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
Party respon ible for overall supervision
\_R-,'.[cr4 I. Authorized hours of operation: 7:00 AM to
Proposed use of grade sAte 5:00 PM, Monday-Friday.
Haul routes are to be approved by City
umber 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. Tota l
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 provided
is correct and agree to comply with all City
ordinances and State laws regulating excavating and
grading, and the provisions and conditions of any
permit issued pursuant to this application.
Signature of Permittee ________
Owner or authorized agent Atp 4~Fina-lcertification Lj
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report
Planting & drainage
rec'd.
Grading permit fee $ 00 WorK compleled
Permit Vaati
Date 7 /7j
Surety bond released
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 . .