HomeMy WebLinkAboutMS 95-02; GAITAUD RESIDENCE; Engineering ApplicationF
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CITY OF CARLSBAD - ENGINEERING DEPARTMENT
APPLICATION
FOR ENGINEERING PLANCHECK OR PROCESSING
Complete all appropriate information. Write N/A when not applicable.
PROJECT NAME: &EWaGRA0 11u6 'DATE:
PROJECT DESCRIPTION:_ PR Riki(U
PROJECT ADDRESS:
LOT NO(S).:I MAP NO.: / Z. APN(S).: Z10 (P
OWNER: 1?&J6 6P1t7?04#D APPLICANT: .
Mailing Address: dZ3_DA15t_L.A.)- Mafling Address:
CIQ P L 6 9i mt4
Phone Number: '(_/J_4_)._'740'_9_O3 Phone Number: (.
I certify that I am the legal owner and that all the above Information
is true and corr the best of my knowledge.
I certify that lam the agent of the legal owner and that all information on
this sheet is true and correct to the best of my knowledge.
Signature e Signature __Date___________
CIVIL -ENGINEER: ob/ 4Y) CZ9ot7 SOILS ENGINEER: 1//Th7 _S/N6'J-r
Firm:&~~V4Vd ôG .DC Firm: epe4 IPF __OTtCHAJIC
Mailing Address: JJS / A Mailing Address: 1'f''*'7
C, 2 7 Cmec/p%_L _ 'FAD 7
Phone Number L (/14 7_5L-\a5.-Phone Number: (CtI )
LtpE-As?cpfrrT.cT ___ ADOm0NAL. COMMENT$ _-
(2
Firm: \ g1 ) _L1 V) c1
Mailing Address:
Phon.Numb.r:
NO, OF DWELLING UNITS: NO. OF LOTS: __/ NO. OF ACRES:________
IMPROVEMENT VALUATION: sewer, water & reclaimed water:_________________
streets and drainage: - water district:__________________
GRADING QUANTITIES: cut cy- fill Cy
remedial import/export -_-.Cy
PLEASE CHECK OFF APPLICATION TYPES ON REVERSE SIDE
P:\D0CS\MISF0RMS\FRM00063 REV 12t15/92
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CITY OF CARLSBAD - ENGINEERING DEPARTMENT
APPLICATION
GRADING PERMIT
PROJECT NAME: GAMAUD IItJ FLII'J PERMIT NUMBER:_____________
PROJECT LOCATION: VACPJi)T LOT w AR DI 4i8cp 14 / _3)
ASSESSOR PARCEL NUMBER(S):______________________________________________
PROJECT DESCRIPTION: FQ RAOi1J6 P4N
OWNER: RGs1
ADDRESS: 43 VA i gy L,ioe 5,, ,'/ P'7 (aS
PHONE NUMBER: _C/a) _i'rn 74O 91o3
I CERTIFY THAT I AM THE LEGAL OWNER OF THIS PROPERTY AND I AUTHORIZE THE GRADING ASSOCIATED
WITH THIS PERMIT.
OWNER SIGNATURE V 0 DATE:
CIVIL ENGINEER wwr ç' d 4ssoc 2Vc
ADDRESS: _135 uUtgeocx DIZ _4G1/2)CO7
PHONE NUMBER:
SOILS ENGINEER: _i?.JP Geoic/-/,J/Cirt.
ADDRESS: /-iu "le ooL Ole A_W#'F
PHONE NUMBER: 614 '3.- 3697
GRADING CONTRACTOR: STATE LICENSE NO.:__________
ADDRESS: CITY BUSINESS LICENSE NO:_______________
PHONE NUMBER:
BASIS OF PERMIT FEES: cy
GRADING QuANrmES: i-C cy cut cy fill
51000 cy remedial CV exportiimpos
VERIFIED
"jjTOTAL PERMIT FEES:. BALANCEDUEO0. _BY:tL.
I hereby acknowledge that I have read the application and state that the Information] have provided is
correct and agree to comply with all City ordinances and State Laws requiring excavating and grading, and
the provisions and conditions of any permit issued pursuant to this application.
APPLICANT NAME _R-J6G 6,,iTht' PHONE NO._746 .&O3
ADDRESS: 43 42181sr 5ii'4m7oc ?,0 6 47
APPLICANT'S SIGNATURE: ) 1Q4koA44 DATE: 61I/q 4
P:\D0CS\MISF0RMS\FRM00065 REV. 01/11/93