HomeMy WebLinkAboutPD 09-04; MADSEN RESIDENCE; Engineering ApplicationY Cr$F CARLSBAD-ENGINEERING DEPASENT'Y 1
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- APPLICATION 3 3 .4 '.'
4. t ENGINEERING PLANCHEd(
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4 CoinIete all ppropi1ate informatIon. WritèN/ when'not a'pplkàble.
PROJECT NAME: DATE: 0^- 2 /- 0g
PROJECT DESCRIPTION: A9)A) 7UY IJLThM?_
PROJECT ADDRESS: (/AUf/L 45fW
LOT NO(S).: MAP NO.: APN(S).: Z4f-
NUMBER OF LOTS: NUMBER OF ACRES: MILES OF TRAILS:
OWNER: -UJQ qy!.) APPLICANT:
Mailing Address: Address: V"\w.c Lu"4 Mailing Address: Z-12._I 1141Jfl-i i'P
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Phone Number: Phone Number: 7bO- 34 7'50'Z-
Fax Number: Fax Number: '7/y') /g (
E-Mail: E-Mail:
I certify that I am the legal owner and that all the ab6ve
Information is true and correct to the best of my knowledge.
Signature: Date: Signature: Date:
CIVIL ENGINEER: jL)1/Z1tI. SOILS ENGINEER: &U'Jflja7 r'51 )frti I?ei
FIRM: 1 FIRM:
Mailing Address: 1AIi)fli J)
itJ yMWD
Mailing Address: 'Z/Z.t LI/Il ri) r- RI)
Phone Number: 7) i4 - 7702_
A) J4
Phone Number: 7(6 - -
Fax Number: . - /ftj --7V-77 Fax Number: 7 - r9- 7 (/7(7
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)
0 Carlsbad Municipal Water District DOlivenhain
S
UVallecitos
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
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SEE REVERSE SIDE
H:iDEVELOPMENT SERVICES/MASTERS/Application for Engineering Plan Check Revised 05101/07
0
I
CITY JWRLSBAD - ENGINEERING DEPART wT
APPLICATION
ENGINEERING PLAN CHECK
Complete all appropriate Information. Write N/A when not applicable.
APPLICATION FOR
(/ all that apply)
FOR CITY USE ONLY
PROJECT
I.D.
DRAWING
NUMBER
DEPOSIT/FEES
PAID
COMMENTS
O Adjustment Plat (AD))
1\
O Certificate of Compliance (CE)
Dedication of Easement (PR)
Type:__________________
Type:__________________
Type:__________________
U Encroachment Permit (PR)
fl Final Map (FM)
Grading Plancheck (DWG) !t,14,fjç (L/L 2
Improvement Plancheck (DWG)
Parcel Map (PM)
Quitclaim of Easement (PR)
Type:
Type:_____________
üReversion to Acreage (RA)
Street Vacation (SN)
O Tentative Parcel Map (MS)
Certificate of Correction
(CCOR)
Covenant of Easement (PR)
Substantial Conformance
Exhibit (SCE)
O Trails O<mile 0> mile
Other
APPLICATION C PTEDBYL
H:/DEVELOPMENT SERVICES/MASTERS/Application for Engineering Plan Check Page 2
RCETEI
AUG,24 2OU
ENGINEERING
DEPARTMENT •
DATE STAMP
APPLICATON RECEIVED