HomeMy WebLinkAboutPE 2.9.22; LA COSTA MEADOWS UNIT 2 LOT 308; Engineering Applicationpplication for Grading PermitS
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT NO. Z,gz
(letter code + number)
Llot
S=subd iv is ion
C=City contract
FOR APPLICANT TO FILL IN
Site Address
-J1c
Surety Bond Bond No.
13775PAID Legal Description Map No. om,&OU)S
bk_e
Surety Company
Subdivision Name Surety Address
)wner Phone Date Filed Rec'd by
Owner's Address -'Mi E*- (J p-L
Cash deposit Rec'd by Date filed
$ ,u&_,
P lans by Civil Engineer R.C.E. The following documents are required and shaL
become a part of the grading permit when they
bare approved.
_Grading plans Specifications
Soil report Vicinity map
Drainage structures Retaining walls
Compaction report _Other
Address Phone &7
L0 S. U.AA's sct
Soil Enaineer R.C.E. Phone
Gradinq Contractor Phone
- PA,
Address Check if supervised
V1S0 \ce.L
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
rty responsible for overI supervision
r',cs I. Authorized hours of operation: 7:00 AM to
Droposed use of grade site 5:00 PM, Monday-Friday.
Haul routes are to be approved by City
Jumber of cibicyards S
Cut Fill Import Waste
Engineer.
Adequate provisions shall be made for
erosion and siltation control.
All slopes shall be planted per direction I of Parks & Recreation Director. Tota l
\2O
>2 /&I 7 77 LJ6,4ZI) #1jç Compacted fills (yes or no)
•
Proposed Schedule of Start Fini sh
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
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report rec'd.
Planting & drainage
Final certification rec'd.
Grading permit fee $ ° Work completed
Surety bond released
Permit Validation
by PWL Date/77
Permit Expiration Date 3'/3 —77
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