HomeMy WebLinkAboutPE 2.11.28; LA COSTA MEADOWS LOT 399; Engineering Application*Application for Grading Permi
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT NO. 2.//.2 '
(letter code + number)
LIot
S=subd iv is ion
C=City contract
FOR APPLICANT TO FILL IN
Site Address Surety Bond Bond No.
Leaal Description Map No.
2r- Off
Surety Company
Subdivision Name
IA /
Surety Address
Owner Phone
A477 (¼/ry 1Kf 448 %07
Date Filed Rec'd by
Owner's Address
40 &M4 ,U* Ave.. 5;,j Ztegp
- Cash deposit Rec1d by Date filed
$
PI by Civil Engineer R.C.E.
'..
r
1/2-/
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
Address hone
J9 cre. "L1,6c.,C,4
SoJj.1 Enoineer R.C.E. Phone
21/21)2J-). 744.! Grading Contractor Phone
Address Check if supervised
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
saonsible f9x- verall supervision
tAowva ,&54r'e. I. Authorized hours of operation: 7:00 AM to
rosed use of grJe site
______
5:00 PM, Monday-Friday.
Haul routes are to be approved by City
lumber of cubic yards
Cut Fill Import Waste
Engineer.
Adequate provisions shall be made for
erosion and siltation control.
All slopes shall be panted per direction ,,e,o I meo I - I .-
of Parks & Recreation Director. Total
Compacte?fills (yes or no) ES
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 this application.
Signature of Permittee___________________________
Owner or authorized agdnt
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report rec'd.
Planting & drainage
Final certification rec'd.
Grading permit fee $ 1p Work completed
Surety bond released
Permit Va11d'ti
by Pate
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