HomeMy WebLinkAboutPE 2.9.24; CARLSBAD SKATEBOARD PARK; Engineering Applicationppl ical-ion for Grading Permit
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
-77 z PERMIT NO."_'
(letter code + number)
L= I ot
S=subdivis ion
C=City contract
FOR APPLICANT TO FILL IN Stt'19-II •cc 712*****139.00
Site Address 1 Surety Bond Bond No.
egal Description Map No. urety Company
ubdivision Name Surety Address
Owner I Phone S?A,W-S IAIC 41 k /
Date H led Rec'd by
Owner's Address
/. 4'-I fq-r2..CoS
Cash deposit Rec'd by Date filed
$ 71e
P lans by Civil Engineer R.C.E.
.t-'\ Vi,qrff .S// S
The following documents are required and shall
become a part of the grading permit when they
are approved.
4_Grading plans _Specifications
Soil report Vicinity map
Drainage structures Retaining walls
Compaction report Other
4J A/
Address Phone
J' 1_14o z,'srq p,z. 4i4i...jgig
Soil Engineer R.C.E. Phone
_
Grading Contractor Phone
Address Check if supervised
l6-jt9.A4//O 5'7,4.4c'Rb grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
arty respon b1e for overall supervision
S,(.ti— 31&k)C I. Authorized hours of operation: 7:00 AM to
roposed use of grade site
S4)-± 41QI
5:00 PM, Monday-Friday.
Haul routes are to be approved by City
Jumber 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 /O I/o I N' I 1I of Parks & Recreation Director. Total
/2 2o0 iii
.{4'tAi7
Compacted fills (yes or no)
7
Proposed Schedule o 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 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 Date 9 /9 77
Permit Expiration Date 2 /1-77
THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THISPERMITISVALIDFORASIX(6)MONTHPERIOD