HomeMy WebLinkAboutPE 2.10.28; LA COSTA MEADOWS UNIT #4 LOT 730; Engineering ApplicationApplication for Grading PermiØ
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT
(letter code + number)
Llot
S=subd iv is ion
C=City contract
FOR APPLICANT TO FILL IN .eu
Site Address Surety Bond Bond No.
Legal Description Map No.
/T73t1 73é7
Surety Company
Subdivis,Lon Name
)
4,4
Surety Address
wrjer Phone 7q-,?j73
-kj t/AZJk S72-2-
Date Filed Rec'd by
Owner's Address
42.P)aX 170?_564. Jsa 2
Cash deposit Rec'd by Date filed
$
Plans by Civil Engineer R.C.E. '
JILA.) ORM C' The following documents are required and shal
become a part of the grading permit when they
are approved.
Grading plans Specifications
Soil report Vicinity map
Drainage structures Retaining walls
Compaction report Other
Address Phone
'4c k\.4-E Ajc '-J/ 2(
Soil Engineer R.C.E. Phone PjroJ tJç{AJEfJ1&JC( 51 'ES
Grading Contractor Phone rc -z'ck 74Gs3 Address Check if supervised
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
arty r sponsi le or overaIsupervision
I. Authorized hours of operation: 7:00 AM to
roposed use of grade site
ociL f2s/7&JCE
5:00 PM, Monday-Friday.
Haul routes are to be approved by City
lumber 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 3€( L/00
of Parks & Recreation Director. Total
Compacted fills (&or'n.o)
Proposed Schedule of Start Finish
Operations (dates)
I hereby acknowledge that I have read the applica-
tion and state that the information I have provide
is correct and agree to comply with all City
ordinances and State laws regi-ting excavating an
grading, and the provisiopa,iJ conditions of ari.y
permit issued pursuant application.
Signature of .Permitte
Owner or authorized agent
6L~_
7
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report
Planting & drainage
Final certification rec'd.
Grading permit fee $ /i'zoo
Work completed
bond released
Permit Validation
by Date 6-
Permit Expiration Date
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