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HomeMy WebLinkAboutCDP 15-20; FLORA REMODEL; Engineering Application4(cityof C'Mlsbad APPLICATION ENGINEERING PLANCHECK E-23 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov Project Name: Fv0f2.A RE t\OVG:L-Date:-..,..:.1..;;;;'Z.......,_;z.....------ Project Description: REl'lt()pE_L,., OF E'I-\STJN G ~OlJS~ V CQt..\SJRUC"T a NE.LU GARAGE Phone Number: Fax Number: - E-mail: 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: Date: Civil Engineer: J?ore RT s V Ku p Firm: :rt\~ se.A "Btl\lo\-\:1 COMPAt,lV Mailing Address: 4 32 2 SE,A JSR) G. It( rLAC~ CARl~~AI)~ CA 4)l008 Phone Number: 7,0-8~~:58(f'v'\ j Fax Number: ____ ,,___,__-,--..,..........,...,---- E-mail: 'S\lK\J:f EtROADtvNi\tRa Cb'ft\ State Registration Number: 2.8 30 2 Fax Number: -E-mail: Signature: ··B lZlb ,• Soils Engineer: IALLO Firm: Mailing Address: Phone Number: Fax Number: E-mail: State Registration Number: Additional Comments: ____________________________ _ IMPROVEMENT VALUATION 1. What water district is the proposed project located in? ( check one) ~arlsbad Municipal Water District D Olivenhain D Vallecitos 2. 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 4~ANTITIES cut 20 cy fill cy remedial l.--cy import cy export W cy E-23 Page 1 of2 REV07/14 Ccityof Carlsbad APPLICATION ENGINEERING PLANCHECK E-23 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov ComDleta all annroDrlate Information Write N/A when not annllcable . APPLICATION FOR ( check all that apply) Project to. 0 Adjustment Plat (ADJ) D Certificate of Compliance (CE) D Dedication of Easement (PR) Type: Type: D Encroachment Permit (PR) 0 final Map (FM) , " fia' Grading Plancheck (DWG/ ~l)Jb~ K:DPf5-2D D Improvement Plancheck (DWG) - 0 Parcel Map (PM) D Quitclaim of Easement (PR) Type: D Reversion to Acreage (RA) D Street Vacation (STV) D Tentative Parcel Map (MS) D Certificate of Correction (CCOR) D Covenant of Easement (PR) U Substantial Conformance Exhibit (SCE) D Trails O<mile O>mile CilOther SNrPF APPLICATION ACCEPTED BY: E-23 Drawing Number I <::f, ;;l..l 5. 1 190-~ II ~'65(o SN \\o-; Page 2of2 FORCITY USE ONLY Deposit /Fees Paid f;[) sA .00 ,'70 Comments ~\nOY Gl ta.&,~ f .ets ~ct rd C5Y\ GRl0-3'7 ~c:n~ f C \ Y> tu-\\ ~ ~ 2\G~S-o t{J\U'J.r~ C7lt\b-; • -"---rom\ of ~ 4?> '-ro) ~,~-~~500 DATE STAMP APPLICATION RECEIVED RECEIVED AUG 15 2016 AND DE\ii::LOPMENT f.:f\!r'•;\ICr REV07/14 CCityof Carlsbad APPLICATION GRADING PERMIT E-24 Development Services Land Development Engineering 1635 Faraday Avenue 760-602-2750 www.carlsbadca.gov I PERMIT NUMBER: ( crf< ~ I la. -rn 4?. Project Name: 1:)-QQ..A. B,~MQOE-L Project Number: r{)P l5-7C\ Project Location: l 55 W8 l..~ U \ AyBN\,Jb Drawing Number: Ll~b-&A Assessor Parcel Number(s): -:Jo~ -I Z. \ -\ 3 Project Description: R~Mntl~L ~~\::rf ING r-\t\lJS'c. CofJ<ff, t--.\~IA) 0A(l.A 6e • {)yl)J Y Owner: Rc-Pe12.i-l=L,Ml~ Address: '2,. 7.,Ci ~ -iE.A~ ~~OOk fZ-OAD Suite: City: \/ p.s It>-. State: CA Zip: tJJZoPJI Phone Number: E>5'o -Cj~ 5, 012c) Fax Number: -I certify that I am the legal owner of this property and I authorize the grading associated with this permit. OWNER SIGNATURE: DATE: Civil Engineer: -g_~BE.R.7" SUKUP Address: L1 ?i z:2.. ~"c.A. ~R\G\·\7 fl-1'..C.'e, Suite: City: C-l<RL~ '2,A. 0 State: cA Zip: "'20() r) Phone Number: --, w-eo1-c1JoO)g Fax Number: Soils Engineer: ,-:;-AST co\.Jt.J T'I SOIi S Address: I a G) i S' B ~ (L, ~ 'c, + 1<,0A 'O Suite: T City: "S ~~-n~ .. 6 State: 'C.A Zip: tJJZ01 I Phone Number: t,,\OJ -Z c;,e-700! Fax Number: , Grading Contractor: State License No.: City Business License No.: Address: Suite: City: State: Zip: Grading Quantities: cut 2,0 cy fill cy import cy remedial ~z. cy export 20 cy Qualified contact person trained in NPDES requirements: Phone Number: Basis of Permit Fees: cy Total Permit Fees: $ Verified By: Balance Due: $ I hereby acknowledge that I have read the application and information provided is correct. I agree to comply with all federal, state, and city laws, ordinances, regulations and policies relating to excavation and grading including, but not limited to, the Federal Endangered Species Act of 1973 and any amendments thereto. I will also comply with OSHA Permit requirements for trenches over five feet deep and the provisions and conditions of any permit issued pursuant to this application. Applicant Name: °i<oll.SR'T VWR-A Address: 1.~0~ e,A s, '6 ROO \<'.. Rt\A 0 Suite: City: ~, ~ '5TA State: C'.A Zip: q;:(OR I Phone Number: 95~ -~ 35 -0'1 Z() Fax Number: APPLICANT'S SIGNATURE: DATE: E-24 Page 1 of 1 REV07/14