HomeMy WebLinkAboutPD 67; COLINA DE LA COSTA-LOTS 2&3; Engineering ApplicationApp Ii cation for Gri;id i ng Permit
CITY OF CARLSBAD
· PERM IT NO··~.....,.,-_.....,..
(letfer code 4 numoer)
L= i,ot
PUBLIC WORKS & BUILDING~DEPARTMENT
1200 Elm Avenue
729-118,1
. $:;:supd iv i,s ion
C:=C.ity contract
FOR .APPll CANT TO FI LL IN
Site Address
7~o~ to,7365 Alica.nte Road La Costa.
~egal: Description Map No.
L9ts 2 .& 3 in La Costa Villa e San Di
Subdivision Name
Colina de La. Costa.
wner
Fountainhead Dev.co.x.
wner 1s Address
9454. Wilshire Blvd.Bev rl
~ans by Civil Engineer
Har R Kondo
·ddress
. 16931 Denver Ave.Gardena
orl E~glneer R.C.E.
Benton~ ineerin Inc.
radfng Contractor
Not selected et.
ddress
Phone
R.C. E.
Phone
Phone
Phone
Check if supervised
rad in
for overa I I supervision
F.i I I lmort
/6850 /686'0 ·
Total
ompacfed fl Ifs (yes or no)
Proposed Schedule of
0 erations (dates)
Start
Waste
Finish
Bond No. ·
Rec'd,, oy
·The follow.ing documents ~re required· and shall
become a part of the gradln_g ,permit when they
are approved •
XGradi,ng pl.ans ¼Specifications
~Sbi·l ·report ·_V.icin.ity map
_xDra i nag,e structures XReta.i n i ng, wa 11 s
_xG_oinpact ion .report · ~Other
I •
2.
3.
4.
SPEC·! Al CONDJT IONS' WHICH ARE MADE
APART ,OF THIS PERMIT
7,:00 AM .to
. I , hereby acknow I edge that I have read the app I i ca-1--£~'-L-_,....=-'~-=--=---.:,;;.=-=--..;...,=;;:.-'--o:.......:,;:,;-:::;.=..~=-'~-
t ion and ,state that the information I have provide
, is correct and agree to comply with al J City DAJE
ordinances and State laws regulating excavating an Ground preparati.on·
grading,, and the provisions and conditions o.f any
permit issued pursuant to this application. Rough·gradi,ng
J fi ~ £? . ' ,/" Compaction re.port rec Id.
, Si§nc:1ture of PermitteeJC~~ , Planting & drainage·
Owner or authorized agent ____ -'---------1---------,---------------------'-'-----'-'----,-Fina I certlficc:1tLon:rec 1d.
Grc1d i n_g permit fee_ $ / 5';] (!) O Work completed
Sur~ty bond released
Date J'v.Q/!' 12.
Perm·it . E:xpiration Date cTA:4 ;e //9'?·~ . 7
THIS FORM WHEN PROPERLY VALIDATED BY SJGNATURE I S A PERM·IT TO DO THE WORK DESCR I BED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD
,;