HomeMy WebLinkAboutPE 2.87.52; CITY FIRE STATION #5; Engineering Application0. 1 Application for Grading Permit 0
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
1200 Elm Avenue
438-6644,
Building Permit Plan Check No.
FOR APPLICANT TO FILL IN
PE NO.? 7 - -54-
Validation by Finance
Department
Site Address ORIDN Surety Company Bond No.
Legal Description Map No. Surety Address
Subdivision Name Date Filed Rec'd by
OtN /V— _S"~, eMne Cash deposit Rec'd by Date filed
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The following documents are required and shall become a part
of the grading permit when they are approved.
— Grading plans Specif ications
— Soil report Geologic Report
- Drainage structures Other
— Compaction report
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W~~i ne r R C.E. Phone
Grading Contractor Phone SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
Address Authorized hours of operation:
7:00 AM to Sunset, Monday - Friday.
Party responsible for-overall supervision
. Haul routes are to be approved by City Engineer. Proposed use of g rade site
F)PZ— 7s)~'w Adequate provisions shall be made for erosion and siltation
control. Number of cubic yards
Cut Fill Import Waste All slopes shall be planted per City Code.
Proposed Schedule of rt F* *sh
Operations (dates)
All fills to be compacted to at least 90% of optimum
density unless noted otherwise.
I hereby acknowledge that I have read the application 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 _Q'A il % t-VIIA
Under City Code Sec. 11.06 170 this grading is:
0 REGULAR GRADING - City inspector will make inspections
listed below.
0 CONTROLLED GRADING - Private grading engineer shall
observe work, coordinate tests, make reports.
INSPECTION DATE INSP. SIGNATURE
Initial - site prep.
ENVIRONMENTAL CLEARANCE -
Date
EIA Log No.
By
Rough - prior to drains
Final - slopes planted
Compaction reports rec'd. Grading permit fee $ Plan check fee $
Private engr. cert. rec'd. Permit Issued
by Date Copies: White-Office; Green-Building;
Permit Expiration Date Yellow-inspector; Pink-Permittee; Goldenrod-Finance
THIS FORM WHEN PROPERLY VALIDATED IS A PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD