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Home My WebLink AboutPE 2.10.24; CARLSBAD LINCOLN MERCURY; Engineering ApplicationT "Application for Grading Pernl CITY OF CARLSBAD PUBLIC WORKS & BUILDING DEPARTMENT 1200 Elm Avenue 729-1181 PERMIT NO./22.jV,29. (letter code + number) Llot 110/7%j%division14.00 BP C=City contract FOR APPI ICANT TO FILl IN Site Address S/32 fl-sw z'1. Surety Bond Bond No. Legal Descriptio Map No Ag et/ 2 ,z Surety Company Subdivision Name &tc1iS L/ flw2- Surety Address )wner Phone c742) Jf#U9 h Date Filed Rec'd by Owners Address / ?éI Cash deposit Rec'd by Date filed Ians by Civil Enineer R.C.E. 1Z4h4,L2 /91',4-h'.r The following documents are required and sh.aL become a part of the grading permit when they are approved. _Grading plans $ Speci fications oil report Vicinity map Dra i nage structures Retaining walls Compaction report Other Address Phone So(I Engineer R.C.E. Phone ,-ix2 rading Contractor Phone Address Check if supervised J/ grading SPECIAL CONDITIONS WHICH ARE MADE A PART OF THIS PERMIT Party responsib(e for overall supervision ~Nphe —,c.)Q..c$6A) I. Authorized hours of operation: 7:00 AM to Pro posed use of rade site' 4/~ 5:00 PM, Monday-Friday. Haul routes are to be approved by City umber 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 I 2O Ic i 0 I of Parks & Recreation Director. Total /2-9b C' 5 ex,ec le o- 5e/ 1IP 4/Oi Compacted fills r no) Proposed Schedule of Start Finish Operations (dates) H-o-7g '-.7 -1 -7? )0'&) ,Pow L?1/4 aU te4o,,v)u,,ef I hereby acknowledge that I have read the app lica- tion and state that the information I have provided is correct and agree to comply with all City ordinances and State laws regulating excavating and grading, and the provisions and conditions of any permit issued pursuant to this application. Signature of Permittee Owner or authorized t INSPECTION DATE INSPECTOR'S SIGNATURE Ground preparation Rough grading Compaction report rec'd. Planting & drainage Final 'certification rec!d. 00 Grading permit fee $ Work completed Surety bond released Fermi alidati n by Date//4 Permit Expiration Date C41,Dv& qcL THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM '. • CITYOF CARLSBAD . N° s 1603 . ENGINEERING DEPT. ENGINEERING DEPARTMENT 729.1181 EXT. 35 ISSUED BY FOR APPLICANT TO FILL IN . : . DATE ISSUED I 2- BUILDING . . . n I ADDRESS ' 3 4 . i.f i0,-k VALIDATION . OWNER e.'t*1 cg iLpnienil / 12/28/787751 6119.30 S I MAILING • . / . . . . . V. . V.. ADDRESS . . .. LATERAL CHARGE COMPUTATION ii ydei-.. . . STANDARD 4" (Max. H. 30', V.10') ••-: • .-• : . . 30' H. _01•. •• FT.- OVER 10'V. © -FT. . A A . •W - :n' v. in' P 2. .3 r— * rvtr ...-.'. ... -• -• - _________________________ OVER 30' H. 55 ____ FT 6-5 >'_EXISTINGBUILDING__• OVER 10'V. . . - • TOTAL CONSTRUCTION COST 3j 00 SERVICE CHARGE (REPAVING ETC.)_ PM 55L Z4• . :-- -. ))TALATERA73 31-- REMARKS: . . .. . . . . .. . LINE CO T DATA U #//cc,4CJ 2 C . . • • . ASSESSMENT DIST. NO. 4/ -. ,. • FRONTAGE COST PER FT.— _____TOTAL -. OTHER .. . CONTRACTOR CONTRACTOR'S. ADDRESS NEW NEW BUILDING LEGAL DESCRIPTION Pet a-?- 2- S LATERAL LOCATION - CONNECTION _FEE I NO. UNITS _ COST PER UNIT _75_TOTAL "7'3 . PUMPSTATIONFEES - UNIT TOTAL :N0 UNITS - COST PER Q0 TOTAL CHARGES (LATERAL ETC.) 11_, 3 LATERAL NO. INSTALLATION DATE— .5 -V •• -V.. '