HomeMy WebLinkAboutPD 87; LA COSTA BOOSTER PUMP STATION; Engineering Application' I ·-'
-App I i cation for Grad i-ng Perm i·t·-·
CITY OF CARLSBAD
PERMIT NO. -,-,-,----'--( .I et fer code + number).
b.=lot .
PUBLIC WORKS & BU I LD I NG DEPARTMENT
1200 Elm Averi.ue
729-1181
·-S,;,subdivi'sion ·-~~-
. C=City contract
FOR APPLICANT TO .FILL IN
s:i te ./~.?i? o0~ i I £P, Surety Bond Bond No.
/ . . JJ/6M ~J~
'Legal Description . Map No. Surety·company
.Sche,d:ule a;tta.ch:ed 255,-02 ..
Subdivision Name Surety' Address
None
Owner L,~.s·s·~e Phone Date Fi{ed Rec'd by
-~~:n· Di.AQ"'o Pineline Comnanv (213 ) .. 624.-9461
.Owner's Address Cash deposlt Rec 1·d by Date fi-led
:6 Hl.'"' . · ' Main .St-r.,.,et Los Ana:e.Jes Calif. 90:014 $
Dian$ by Ci vi I Engineer R.C.E. The fol io~ing dbcumenfs are required and shal I
J •. M .• A;bboud. z·o:0(?4, become{ a pa.rt of the. grading permit when they
~ddress Phone are approved.
. :Same-as. Lesse:e _Grading p I ans _. _Specifications
Soi I Engineer R.C.E. Phone _Soi·I report _Vicinity map
Loui:s J • .Le:e 1412·9 (714:l ZZ4-.2911 _. _Ora i nage structures · __ . -• Reta in i ng wal Is
GradJng Contractor Phone _Compaction ·report Other
. Owner /Builder ... -.-.
-Address Check if supe·rv i sed ·sPECIAL CONDIT'IQNS WHICH ARE MADE
oradinQ X A PART _OF THIS PERMIT
Party responsible for overa 11 supervision
.H •. v. .Co-r.rodi I • Autborized hours of operatJon: 7:00 AM to
1:i·roposed use of grade site . 5:00 PM, Monday:-Fri:day.
B.ooste·r Fum.P .:Station 2. Haul routes are to be aooroved bv Citv
Number of Cl,Jbi<;: yards Engineer.
·Cu.t. Fi 11 lmoort Waste 3. Adequate provisions shal I b.e .made for
erosion and s i I tat ion co'r-i.tro-1.
.2·9.8.0' I .23'90 I Q I' 4. Al.I .slooes sha 11 be o.l'anted oer .direction
of Parks & Recreation Di rector. Total
.K;ompacted fi 11 s (yes or no)
Yes: ...
Proposed Schedule of Start Finish
Ooerations (dates) 1.0.-14--74 11.·-15-74 ..
I hereby acknowledge that I· have read the app Ii ca.,;.
tion and state that the information I have provi dee .. INSPECTOR'S
is correct and agree to comply with a I l City INSPECTION DATE SIGNATURE
.ordiriances and State laws regulating excavating anc Ground preparation
grading; and the provis·ions and conditions of any ,. . .
Rough :gr.ad;i ng permit .issued p:ursuant to this appl icatio11 .• .
Signature of Permittee ~ Compact i,on report rec'd.
.•.
Pl anting & drainage'
Owner or authorized agenM ~ F_in.a.1 ce-rti .f icati oh rec'd. ·. . .R. R. McDan1: .
Gradrng permit fee .$ 9·0 ._o:o PAIP 7,9,7~ Work comp I eted
Surety. ·boi:id· rel eased
,Perm.it Validation
by_ Date
-Permit Exp·i ration Date ----,,-..------,.-----TH :IS FORM WHEN PROPERLY VALi DATED BY S l:GNATURE IS A PERM·IT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (_6) MONTH PS:Rl:OD