HomeMy WebLinkAboutPE 2.10.20; LA COSTA SOUTH LOT 528; Engineering ApplicationOpplication for Grading Permit 46
C ITY GCARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT NO. p g zIOzo
(letter code + number)
LIot
S=subdivis ion
C=City contract
FOR APP! ICANT TO Fill IN
Site Address 4/ Surety
Le aal De
,
scripjio Map No Surety Company
Subdiv! op Name
- 7
Surety Address
-
)wner Phone
lv~s_ JS 3 -3 1-3 9
Date Filed Rec'd by
eo. ___
Cash deposit Rec'd by Date filed
$
The following documents are required andhal
become a part of the grading permit when they
are approved.
Grading plans Specifications
,XSoil report Vicinity map
Drainage structures Retaining walls
_Compaction report _Other
Ia by Ci in %AW 5 fl1Ig A ddress Phone
a'n-Z 4j5,ji4 7,0-Z11?l
Soil Engineer R.C.E. Phone
Grading Contractor Phone
\ddress Check if supervised
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
art. responsible for overall supervision
I. Authorized hours of operation: 7:00 AM to
Droposed use of grade site 5:00 PM, Monday-Friday.
Haul routes are to be approved by City
Number of cubic yards
Cut Fill Import Waste
Engineer.
Adequate provisions shall be made for
erosion and siltation control.
All slopes shall be planted per direction -< )D <' lo I of Parks & Recreation Director. Total
Compacted fills 7ôr no)
Proposed Schedule of Start Fi ih
Operations (dates)
I hereby acknowledge that I have read the applica-
tion and state that the information I have providec
is correct and agree to comply with all City
ordinances and State laws regulating excavating anc
grading, and the provisions and conditions of any
permit issued pursuant to this application.
Signature of Permittee___________________________
Owner or authorized agent
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report rec'd.
Planting & drainage
Final certification rec'd.
Grading permit fee $ Po r Work completed
Surety bond released
Permit I
by Date/Di///7
Permit Expiration Date A4-.
THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THISPERMITISVALIDFORASIX(6)MONTHPERIOD