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CITMV CARLSBAD - ENGINEERING DEPARNT
APPLICATION
ENGINEERING PLAN CHECK
Complete all appropriate information. Write N/A when not applicable.
PROJECT NAME: L, M A-,,-td( A DATE:
___________
PROJECT DESCRIPTION: ___r_1 ç----:l 1JlTD/\
PROJECT ADDRESS: 2400 £A—
LOT NO(S).: MAP NO.: APN(S).: 2,1 (o 1 O• S
NUMBER OF LOTS: NUMBER OF ACRES: MILES OF TRAILS:
OWNER: JPc~ov Lec,4 -(1igA-5vl-'r-) APPLICANT:
Mailing Address: 21'O 3 11r7 ,kV' 4 Mailing Address:
1,-0 2'6Z7a/
Phone Number: Th,o Phone Number:
Fax Number: Fax Number:
E-Mail: E-Mail:
I certify that I am the legal owner and that all the above
information ru best of my knowledge. 4corre
Signature. )Date:_to/s7/01 Signature: Date:
CIVIL ENGINEER: uI(Iis "ry iivvt.1(ervv
FIRM: L)oc.
Mailing Address: 3L(3( tfr Pcv'
SOILS ENGINEER: U. 4rev
FIRM: Aiecr-j -e€i,e4
Mailing Address: _i7 z-c C-v A-L '.
kK. ,C '? 7_f o3
Phone Number: 0 Phone Number: lu'-I. ç.
Fax Number: 20 . Fax Number: 3"1O
E-Mail: E-Mail:
State Registration Number: State Registration Number:
ADDITIONAL COMMENTS:
IMPROVEMENT VALUATION
What water district is the proposed project located in? (check one)
Carlsbad Municipal Water District f101ivenhain flVallecitos
If in the Carlsbad Municipal Water District, what is the total cost estimate, including the 15%
contingency fee, for water and reclaimed water improvements, sewer (for Carlsbad Municipal
Water District only), street, public (median) landscape and irrigation, and drainage improvements
(if applicable)? $
GRADING QUANTITIES
cut _______ cy fill _______ cy remedial cy import _______ cy export cy
SEE REVERSE SIDE
H/DEVELOPMENT SERVICES/MASTERS/Applicalion for Engineering Plan Check pl O)_ th5101101
I
CIT1W CARLSBAD - ENGINEERING DEPAW1ENT
APPLICATION
ENGINEERING PLAN CHECK
Complete all appropriate information. Write N/A when not applicable.
FOR CITY USE ONLY
APPLICATION FOR PROJECT DRAWING DEPOSIT/FEES COMMENTS
( v" all that apply) I.D. NUMBER PAID
Adjustment Plat (AD])
Certificate of Compliance (CE)
0 Dedication of Easement (PR)
__
Type:__________________
Type:__________________
Type:__________________
fl Encorachment Permit (PR)
Final Map (FM)
Grading Plancheck (DWG)
Improvement Plancheck (DWG)
0 Parcel Map (PM)
Quitclaim of Easement (PR)
Type:__________________
Type:__________________
Type:__________________
LI Reversion to Acreage (PA)
Street Vacation (STy)
Tentative Parcel Map (MS)
Certificate of Correction
(CCOR)
Covenant of Easement (PR)
LI Substantial Conformance
Exhibit (SCE)
Trails []<mile []> mile
fl Other
APPLICATION ACCEPTED BY:
DATE STAMP
APPLICATON RECEIVED
H/DE VELOPMENT SERVCESIMASTERS/AppIicatioo for Engineering Plan Check Page 2 Revised 05/01/07