HomeMy WebLinkAboutPE 2.11.37; PARK DRIVE BELLAVISTA LOT 4; Engineering ApplicationApplication for Grading Permø
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT
(letter code + number)
LIot
S=subd iv is ion
8CCif contract, n OiI25 no soan n
FOR _APPLICANT _TO_ FILL _IN
Site Address S Surety Bond Bond No. i-i' (p 00 ,'iZA L, LS186? 619.
Legal Description Ma No. Surety Company 2f_i0 k_f ,,f 4'e//e_1,j7k_'2Ls2
Subdivision Name Surety Address
Owner Phone
, E 733
Date Filed Rec'dby
Owner's Address
/75? 6a aia_ C Ls6g1',
Cash deposit Rec'd by Date filed
$
ins by Civil Engineer R.C.E.
lAddre'ss
The following documents are required and shall
become a part of the grading permit when they
are.-approved.
rading plans Specifications
/Soi I report Vicinity map
Drainage structures Retaining walls
_Compaction report _Other
Phone
/58NauezIto, 2n&z -9S
Soil Engineer R.C.E. Phone
(j///la,pri. Riwe.cAo_e 011.y1op
;radina contractor Phone
ddress Check if supervised SPECIAL CONDITIONS WHICH ARE MADE
grading A PART OF THIS PERMIT
Day responsible for overall supervision
k,c(a'i/ f I. Authorized hours of operation: 7:00 AM to
ropsed use of gcde site 5:00 PM, Monday-Friday.
Haul approved _routes _are _to_be_ _by_City
Jumber of cubic yards Engineer.
Cut Fill Import Waste Adequate provisions shall be made for
erosion and siltation control.
All slopes shall be planted per direction 5o I /o I I of Parks & Recreation Director. Total
Compacted fills (yes or no)
Proposed Schedule of Start Finish
Operations (dates)
I hereby acknowledge that I have read the applica-
- INSPECTION DATE INSPECTOR'S
SIGNATURE
tion and state that the information I have providec
is correct and agree to comply with all City
Ground preparation ordinances and State laws regulating excavating anc
grading, and the provisions and conditions of any
permit issued pursuant to th
- Rough grading
Compaction report rec'd.
Signature of Permittee Planting & drainage
Owner or authorized agen Final certification rec'd.
- Grading permit fee $ Work completed
..
Permit Vat~ni
by 8k/8
urety bond rel eased
I S Permit Expiration Date 45
THIS FORM WHEN PROF 'ERL/ VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD