HomeMy WebLinkAboutPE 2.8.24; 130 & 140 HEMLOCK LOT 6 & 7; Engineering ApplicationApplical-ion for Grading Permit I-K 4
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT NO )I t
-(Ietter code..± number)
Llot
S=subd iv is ion
C=City contract
flC 1376
FOR APPLICANT TO FILL IN
Site Address
130 -11 J/O 11e'i2eR
Surety Bond Bond No.
Legal Description Map No.
Lot L 4 7 ,nil3i- g /. Ailsodes Ms4P/7417
Surety Company
Subdivision Name Surety Address
)wner Phone
f'?''i,t'
Date Filed Rec'd by
Owner's Address
c2pos, dd9R8a,2 &. 61 4514tISIDE
Cash deposit Rec'd by Date filed
$
Ians by Civil Engineer R.C.E.
_1;9-MC-5 'c' 1,ppii1 The following documents are required and shal
become a part of the grading permit when they
are approved.
Grading plans >Specifications
,Soi I report Vicinity map
Drainage structures Retaining walls
Compaction report _Other 7aI-,f2Ac
ddress Phone
335- OI-'' 4ilj= ct,4L 7..221-O
Soil Engineer R.C.E. Phone
7?-,
Grading Contractor Phone
Address Check if supervised
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
Dartv responsible for overall supervision
/?ñHX 5py7E A— I. Authorized hours of operation: 7:00 AM to
'Apposed use of grade site
j/ 77/p/ _ey e s
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. I ota I
Compacted fills 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 provide
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 o this appIicaton
Signature of PermitteLlrLtA
Owner or authorized a
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
- Rough grading
Compaction report rec'd.
Planting & drainage
Final certification rec'd.
Grading permit fee $ 7 Work completed
Surety bond released
Per mf Validation
b J(/ Date/p y ,
Pefr4t pi ration D'te W, 134y
(I 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