HomeMy WebLinkAboutPE 2.10.39; BELLAVISTA LOT 5; Engineering ApplicationI.
Building Permit Plan Check No.
Application for Grading Permit
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
1200 Elm Avenue
729-1181
PENO. air39
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Department
FOR APPLICANT TO FILL IN
Site Address Surety Bond Bond No.
Ll Description '- Map No.
9LLA ¶acy 'Z 62.
Surety Company
Subdivision Name Surety Address
Owner Phone
(ZoMAQ c D0 Crn4163-SBtB
Date Filed Rec'd by
Owner's Address
3'5 L'JiJ
Cash deposit Rec'd by Date filed
$
Plans by Civil Engi eer R.C.E.
A.... q E9
The following documents are required and shall become a part
of the rading permit when they are approved.
i/Grading plans Specifications
(7S oil report -Retaining Walls
_Drainage structures ______ Other
___ Compaction report
________________________
Address Phone
.J. 2&1 114;) -Z,60_ 432t
Soil Engineer
_____
R.C.E. Phone
Gradino Phone 9L
Address t /3 CtAZ1 .
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
P responsible for ove supervision
V y'-o 1 Authorized hours of operation:
7:00 AM to 5:00 PM, Monday - Friday. Pro osed use f grade site
Haul routes are to be approved by City Engineer. ______________________________________________________•
Number of cubic yads
Adequate provisions shall be made for erosion and siltation
control.
Cut Fill Import Waste
All slopes shall be planted per direction of Parks,&
Recreation Director. Proposed Schedule of Start Finish
Operations (dates)
All fills to be compacted to at least 90% of optimum
I hereby acknowledge that I have read the application and state that density unless noted otherwise.
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
0^
INSPECTION DATE INSPECTOR'S
SIGNATURE
.Ground preparation
Owner or authorized age nt Rough grading
ENVIRONMENTAL CLEARANCE 'I 1-7 Compaction report rec'd.
ElA Log No.
Date
L
Planting & drainage
Final certification rec'd.
Grading permit fee $r ________________________________________________________________
Work completed
Permit Issued
6.vt/! __________________
Surety bond released
by #_ Copies: White-Office; Green-Building;
Permit Expirafion Date -5 ' Yellow-Inspector; Pink-Permittee; Goldenrod-Finance
THIS FORM WHEN PROPERLY VALIDATED IS A PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD