HomeMy WebLinkAboutADJ 501; ISLA MAR; Engineering ApplicationCITY O_ARLSBAD -'ENGINEERINc4EPARTMENT
APPLICATION
FOR ENGINEERING PLANCHECK OR PROCESSING
Complete all appropriate information, Write N{A when not applicable,
PROJECT NAME: Isln Mat
PROJECT DESCRIPTION:_-'I_O_I'---..::::--7-'"----!..~_'_'_'_¥_...u....::~~--....,..----~,.f_==~--....---
PROJECTADDRESS: ______________________ -,~~~~~~~~~~-~~
LOT NO(S).: ·6) ~ t?£.-. MAP NO.: qD -'V
OWNER: ILi If>Je.n
Mailing Address: I]'?! 0 IZWlni 11 Av(/,.
lrJ!i ):J~ I CA q2TI4 ,
Phone Number: (]!4 1 J5b-J?J3
I certify that I am the legal owner and that all the above information
is true and co e to the best of my knowledge,
Signature Date5h .. ~)~1 I I
Firm:
Mailing Address: Ur
Q2.014-
Phone Number: ) 0 f '2,-B f$ ~
State Registration Number: -..-.:~:...1....l......!r.o::....q...L.:?~ __________ _
LANDSCAPE ARCHITECT:_'--NI...-'-IA _____ _
Firm:
Mailing Address:
Phone Number:
State Registration Number: __________ _
APPLICANT: 5Qql0 wa4 C,)j) E njlr){(,erjn~
Mailing Address: ~D?:5~rllrlL ~( .. 1t 175 f'YH()~~ qz, I'{ .
Phone Number: (11'-1-) B51.-BE? 57-
I certify that I am the agent of the legai owner and that all information on
this sheet is e and correct to the best of my knowledge,
vV. Date?; /1/& 10, 1
N-iA
Firm:
Mailing Address:
Phone Number:
State Re!=1istration Number: ______ ....;..,... _____________ __
ADDITIONAL COMMENTS:_-..,.---",..--_________ _
NO. OF DWELLING UNITS:~ LFMP ZONE: ___ _ NO', OF LOT~7t t 5"L NO, OF ACRES:, __
IMPROVEMENT VALUATION: sewer, water & reclaimed water:. _____ _
Water District (Cir~l~l o~~,:: :" Carlsbad Municipal Water District Olivenhain' Vallecitos
streets t:ln~t<lirairi'age;~,;_' _' _______ _ landscape: ____ .--:. ______ _
GRADING Q~~~T!.T.I:~~:+-... ~, ___ Cy cut _____ cy fill....;.,.,. _____ _ cy
remedial cy import/export cy
PLEASE CHECK OFF APPLICATION TYPES ON REVERSE SIDE
P:\DOCS\MISFORMS\FRM00063 REV 04/28/95
APPUCATION FOR
(CHECK ALL THAT APPLy):
Plat
o Certificate of Com
o Dedication of Easement
Plancheck
o Street Vacation
o Tentative Parcel Map
o Certificate of Correction
o Covenant for Easement
D Substantial Conformance Exhibit
P:\DOCS\MISFORMS\FRM00063 REV 04/28/9