HomeMy WebLinkAboutPD 446; CALLAWAY BLOCK RAMP; Engineering ApplicationCITY O•ARLSBAD - ENGINEERING %PARTMENT
APPLICATION
GRADING PERMIT
PROJECT NAME: f6L0C P-/kYvif _PERMIT NUMBER: C1( ?ZT
PROJECT LOCATION: LMD/i) COU(Zf
ASSESSOR PARCEL NUMBER(S):
PROJECT DESCRIPTION: (ZJ74P AVOfS74 (J/3(1
OWNER: &oF
ADDRESS: l2-' W7Fi'OtO ROMO MO) c-,4 9Zoo
PHONE NUMBER: 6(ci /3/ "77(
I CERTIFY THAT I AM THE LE 9AL OWNER OF THIS PROPERTY AND I AUTHORIZE THE GRADING ASSOCIATED
WITH THIS PERMIT. 7/ ,
OWNER SIGNATURE DATE:
CIVIL ENGINEER: / 7L)f /
ADDRESS: _41so U4 jeL1(_p1 ft-LPr( LL, sr 30 LA doLLp LO 3-7
PHONE NUMBER: - cc?- -00 73
SOILS ENGINEER: So 4) CkL11=, Oi1S " flAJ -&
ADDRESS: (O>( OQfl SALO WC60 C/ 921
PHONE NUMBER: '1o0
GRADING CONTRACTOR: G,F J( L L 0(4< 7(LAOuJ, STATE LICENSE NO.:47 2-9
ADDRESS: -° DI3TR-(6UTfOr) LiA'-(, VS'P) CITY BUSINESS LICENSE NO: (2M3B9 PHONE NUMBER: 971..- 6000
BASIS OF PERMIT FEES: cy GRADING QUANTITIES: /00 cy cut -700 cy fill cy remedial ' 00 cy e*pertlimport
VERIFIED TOTAL PERMIT FEES: BALANCE DUE: BY:
I hawy acknowlefte that I have read the spokAbon aid ,ovid is correct. I mWoo to conI' widt d fsdirl. stat., aid city Ivs, arditlancea. ,equations and policies ,Utinq to acav~ aid grivi9 but not Iin'it.d to. the Fads Endaig.d Species Act of 1973 aid aw ..an..t. th.,sto, 0514* Pwylt r.qu.,.maits to, t,aidi.. eve five fist d..p aid the prowsions aid candibcns of uiy pa t ism piwaait to *1. appkaborL
APPLICANT NAME_VU.1 F/VTI SiV141T$
PHONE NO.__________ ADDRESS: 63 /711L- c- 7ç01 cñ z/a,
APPLICANT'S SIGNATUR DATE: 7
P:\DOCSMISFORMSFRM000e5 7 REV. 12/22193
CITY OF ^amLSBAD. ENGINEERING V#PARTMENT
:.APPLICATION
FOR ENGINEERING PLANCHECK OR PROCESSING
OJECTNAME:-.Block/Ppscpl Ramp DATE:____________ 7R
PROJECT DESCRIPTION:Construct connecting driveway between two parking lots
and repair existing parking areas
PROJECT ADDRESS: 9997 Tandrni Ct. 99 60 Pnsr'Rl Cf
LOT NO(S).: Lots 18&19 MAP NO.: Map 10330 APN(S).: 212-061-10
Parcel 4 PM 13194 212-061-12
OWNER: Callaway Co1f APPLICANT: C.11away_(c14'
MaillngAddr.u: 2285RutherfordRoad Mailing Address: 2285RutherfordRoad
Carlsbad, CA92.008 Carlsbad,CA92008
Phone Number 619 _931-1771 PhonNumber 619)_931-1771'
I certify that fam the ii ownerarid that alt th. above Information I certify that I am the ag.nt of ths legal own. and that aH Information on
this sheet Is true correct to the beet my knovvl.dg.. is true and cct . best of m
Z~~f-ha'te Signature 2f(74 Signature/_- ate___________
AndrewGracey Andrew Grace
CIVIL ENGINEER: Mark Rows on SOILS ENGINEER: ChrisChristian
Latitude 33 Firm:. Firm: q0i l tz
IInAddress: 4180La Jolla Village Dr. Mailing Address: Testing
Ste.330,LaJolla,CA92037
Phone Number: 6 19)_552-0033 ' Phan* Number
State Registration Number, 30836 State Registration Number
LANDSCAPE ARCHITECT: ADDITIONAL COMMENTS:____________________
Firm:
Mailing Address:
Phone Number:
State Registration Number
NO. OF DWELLING UNITS: LFMP ZONE: NO. OF LOTS: NO. OF ACRES:_____ IMPROVEMENT VALUATION: sewer, water & reclaimed water:_______________
streets and drainage: Iandscape ________ water dlstrt_________________ GRADING QUANTITIES: Cy cut 1 00 - cy tin 75 cy
remedial cy importtejq= 600 cy
-. PLEASE CHECK OFF APPLICATION TYPES ON REVERSE SIDE
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P:\00CSMlSF0RMSFRM000S3 REV 1211/91
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APPUCATION ACCEPTED BY
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MASTER PROJECT I . .
RECEIPT NUMBER
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PRELIMINARY SIERRA SYSTEM INPUT INAL_______
SIERRA SYSTEM INPUT NITIAL_________________
R BASE INPUT INITIAL_____________
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