HomeMy WebLinkAboutPE 2.11.02; LA COSTA ESTATES NORTH BOLERO; Engineering ApplicationApplication for Grading Permit 10) PE NO.
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
1200 Elm Avenue (IQ1j Fiá?e 5000 IL 729-1181 Department
Building Permit Plan Check No.
FOR APPLICANT TO FILL IN
Site Address
'-/ du Surety Bond Bond No.
Legal Description
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Map No. Surety Company
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deposit Rec'd by Date filed
Plans by Civil Engineer R.C.E.1 The following documents are required and shall become a part
of the arading permit when they are approved.
Address Phone S Grading plans Specifications
Soil report Retaining Walls ineer R.C.E. Phone Z ng
: -A,<~ ?g1 ,,Drainage structures _____ Other
Compaction report Gra ractor Phone
Ad SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
Part SL ponsible for ove Authorized hours of operation: j) 7:00 AM to 5:00 PM, Monday - Friday. ______________________________ Proposed usf
Haul-routes are to be approved by City Engineer. 5 f R
Number of cubic yards
Adequate provisions shall be made for erosion and siltation
control.
Cut Fill Import Waste
6O 4. All slopes shall be planted per direction of Parks &
Recreation Director. Proposed Schedule of Start Finish
Operations (dates)
5. 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 i ed pursuant to
this application.
INSPECTION DATE INSPECTOR'S
Signature of Permittee SIGNATURE
Ground preparation
Owner or authorized ____________________________ Rough grading
ENVIRONMENTAL CLEARANCE
- In.
Compaction report rec'd.
Date ____
EIA Log No.
_______ Planting & drainage
Final certification rec'd. By
Grading permit fee $ / Work completed
Permit Surety bond released
//—, bv ?~K/ _eq14 —Date _eD . - ____ — .---
Permit Expiration Date Yellow-inspector;Pink-Permittee; Goldenrod-Finance
THIS FORM WHEN PROPERLY VALIDATED IS PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD