HomeMy WebLinkAboutCT 74-14A; TEMPLIN HEIGHTS UNIT 1; Engineering Application~pPlicat~on for Grading permit~
CITY OF CARLSBAD
PERMIT NO.
( letter co-:'d-e-+:--n-u-mb:"""er)
L=lot
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue 729-I 181 ,',. ~) ,. -'
S=$ubdivision
C:;:City contract
FOR APPLICANT TO FILL IN
Site Address
Legal Description Map No.
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Subdivision Name
~wner Phone
, i L /:! 7.'f:: .~(r'!C "/ -;/ '7 -t·///7
~wner' s. ,Addres.s
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Plans by Civil Engineer R.C.E.
. -.-/ -:," ,"?'j l' I ' I ~ ~ 1 .I I i it." .~-J ..:'/..'..: ..I-/ h:' ..-
~ddress Phone
'./ ~ /'. 7-7 .~, "= "i '~I • J ,,' I ,J '
60i I Engineer, R.C.E. Phone
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Grading Contractor Phone
Address Check If supervl~ed
grad i ng t."'·
Party responslbl,e for overall supervision
i.,/.. ,,' ilL:,'
Proposed use of grade site
_ • y'-,/ ~: ,::. ;~: I~). I II-.. " :,.;)£ t /"
Number of cubic yard5
Cut FII I Import Waste
Total
• j ;I '.', ,I ~3'
~ompacted fi I Is/tyes;or no)
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Proposed Schedule of Start
Operations (dates) .. :::-;'"., 77
Finish =7!~ {J 77
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Surety Bond Bond No.
Surety Company
Surety Address
Date Fi led Rec'd by
Cash deposit
$
Rec'd by Date fi led
The fol lowing documents are required and shall
become a part of the grading permit when they
are !Jpproved.
0Grading plans
_'_. So i I report
Drainage structures
.~'-tompaction report
___ Specifications
_Vicinity map
_Retaining walls
_Other
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
I. Authorized hours of operation: 7:00 AM to
5:00 PM, Monday-Friday.
2. Haul routes are to be approved bJL City
Engineer.
3. Adequate prOVisions shal I be made for
erosion and siltation control.
4. All slopes shall be p·lanted per direction
of Parks & Recreation Director.
7"
• " '0 f 1
I hereby acknowledge that I have read the appllca-~ _____________________________ ~ ____ ~~
tlon and state that the information I have providec INSPECTION DATE INSPECTOR'S
Is correct and agree to comply with all City SIGNATURE
ordinances and State laws regulating excavating anc Ground preparation
gradl ng, and the provis Ions and conditions of any ~-Ro-u-9-h--g-r-a-d-:-In-g----'-' ...------------------
permit issued pursuant to this application.
,,-... .' \ Compact Ion report rec' d.
S i gnatu re of Perm j ttee ,f.,' . ~ .-,~, /~ ./. ~':'~.>!. /, (, P I ant I ng & d ra i nage .,.' 1
Owner or author i zed age nt_I_'~-:':-'_' _._,-;0-_ .. +,' ,-,-,,,-, ;.,.... -..... ~.,...----~'.---'----F-i n-a-I-c-e-r-t-j -f -j c-a-t-j-o-n-re-c.,-':-d-.--------'--
Grading permit fee Work completed
surety bond released
Permit Val idation
.-' by ___________ --.!,-"'-J _____ -...;Date ' ," .... -:
Permit EXpiration Date 1.1 ',; .. ', '7. / .-..
THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD