HomeMy WebLinkAboutPE 2.9.12; TEMPLIN HEIGHTS UNIT 1; Engineering ApplicationPERMIT
q
(L pplica-tion for Grading Perm its (letter code + number
CITY OF CARLSBAD Llot
PUBLIC WORKS & BUILDING DEPARTMENT S=subdivision
1200 Elm Avenue C=City contract
729-1181 /?4/ 4t'1
/ 7o / R r £10.
FOR APPLICANT TO FILL IN
Site Address Surety Bond Bond No.
Legal Description Map No.
iêdn PUM #ov6#rj 0 CT 7 '# -1St
Surety Company
Subdivision Name
k -raM 11-,616 ,tr5_a.,u, r Nô,I
Surety Address
ner Phone
IfriLfi)_Z'Xiyc
Date Filed Rec'd by
Owner's Address
~?074 4j 3 4,V.E iV#w&Tv'24.,F Cash deposit Rec'd by Date filed
$
P lans by Civil Engineer R.C.E.
$Qjqd $,7?t &e4Z,uc_/3g/7 The following documents are required and shal
become a part of the grading permit when they
are approved.
t-ad i ng plans /Specifications
i8il report Vicinity map
Dy i nage structures Ie-ta i n i ng walls
Compac1-ion report 7bther
Address Phone
At 546 ã77 X7- OWU 7 31
Soil Enginee R.C.E. Phone
So,i ,1149rL T5T/AW 44 i'Ve 0w7V
;radig Contractor Phone
Address Check if supe9.sed
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
arty responsible for overall supervision
mLm P5 I. Authorized hours of operation: 7:00 AM to
Droposed use of grade site
/#JtE PAmii....Y PZV.
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 0/90D0 K.4.sMm,ie ,6 of Parks & Recreation Director. Total
Compacted fillsor no)
0 Lc Proposed Schedule of Start Finish
Operations (dated) 7,9w 77 68 77
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
1- 167 9*~Alplc_rpll
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report
Planting & drainage
Final certification rec'd.
Grading permit fee $ /74.9 . V Work completed
Permit Validati n
by(, Date 7/77
Permit Expiration Date____________________
THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE
urety bond released k.
IS A PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD