HomeMy WebLinkAboutPE 2.10.27; LEWIS HOUSE; Engineering Applicationpplication for Grading Permits
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT NO.__
(letter code + nurer)
L= I ot
Ssubd iv is ion
C=City contract
4/03/7937 102.00 BP
FOR APPI IANT TO Fill IN 00013756 4/03/79 IU.UU TL
Site Address
Lo APA
Surety Bond Bond No.
Legal Description Map No.
AQ- IL J0 4-
Surety Company
Subdivision Name Surety Address
)wner Phone
44.21JCLL', 4114-hia
Date Filed Rec'd by
Owner's Add ss Cash deposit Rec'd by Date filed
$
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4- LkL' - Ii-io
The following documents are required and shal
become a part of the grading permit when they
are approved.
jGrading plans jSpecifications
Soi I report )( Vicinity map
Drainage structures jRetaining walls
_Compaction report _Other
\ddress Phone
O Li LLLkIL'?ILL 4'( LA tj d Li iAf
Soil Enaineer R.C.E. Phone
L.T Pti'i *c'I1.- (74-_#gi...
rading Contractor Phone
ddress Check if supervised
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
)arAy
responcible for overall supervision
L LIZ .'>- A I. Authorized hours of operation: 7:00 AM to
ropsed use'of grade site
C~ h4)1
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 I R9
of Parks & Recreation Director. Total 118q C.X.
Compacted fills (yes or no)
Proposed Schedule of Start Finish
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 ar(d conditions of any
permit issued pursuant to this appl icatio'I
Signature of Per i Permit-tee / )
Owner or authoridage[
INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report rec'd.
Planting & drainage
Final certification rec'd.
Grading permit fee $ Work completed
Surety bond released
ref-ItT Vi9L4 ftT1OA1
by 7J - Date 1--7 I -T*tc PEM rr $1/JPP =^O A WfJOD
jwyTh- I*J1(iJ -29-3O
Permit Expiration Date 7!j
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
Permit Validation