HomeMy WebLinkAboutCUP 01-12; CASA MONTESSORI DE VISTA SCHOOL; Engineering ApplicationCrn CARLSBAD - ENGINEERING DEPARSNT
APPLICATION
ENGINEERING PLAN CHECK
Complete all appropriate information. Write N/A when not applicable.
PROJECT NAME: L. DATE: --ZZ
— LOA
PROJECT DESCRIPTION: '7
PROJECTADDRESS:
LOT NO(S).: MAP NO.: APN(S).:
NUMBER OF LOTS: NUMBER OF ACRES:
OWNER: . L.icSi4jz APPLICANT: JI6 lA(Lti2
Mailing Address: I4 _,.4/. Mailing Address: JJ_
1t5t3/r2_
Phone Number: (7o)_7 _— Phone Number: (7)_'14_4-a
Fax Number: Fax Number: (
_1
N.
E-Mail: E-Mail: ino
I certify that I am the legal owner and that all the above
Information is true and correct to the best of my knowledge.
Signature: j _t.4..y.tPate:fr7..3-4
'.1
Signature _______
Date:
CIVIL ENGINEER: ri-i ILIP _t SOILS ENGINEER: jz-64t4
FIRM: AEF~ FIRM: tJ ,C.
Mailing Address: y')1 i,4Ar( _ Mailing Address: 5±41_L4412_kLA-(
~1P,_4A. ~C2,44.
Phone Number: (ô) _7 -zod Phone Number: (a;)-(
Fax Number: (7)_71. Fax Number: (26)_3l _c"! 1.5
E-Mail: rq 1L7 E-Mail:
State Registration Number:'772. State Registration Number: 194e'
ADDITIONAL COMMENTS:
IMPROVEMENT VALUATION
What water district is the proposed project located in? (check one)
[]Carlsbad Municipal Water District DOlivenhain Ovanecitos
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 14/02 (ii2A I'2..
-,•'c'c',.. p4cr for Enqineering Plan Check '-1.-i r '.-'s