HomeMy WebLinkAboutPE 2.11.19; CHURCH OF JESUS CHRIST OF LATTER DAY SAINTS LOTS 12 & 24; Engineering Application' Applicatiàn for Grading Permit
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
1200 Elm Avenue
729-1181
PENO.4T.J4/
Validation nance 0 00
Department
Building Permit Plan Check No. 71-6 6:3
FOR APPLICANT TO FILL IN
Site Address Surety Bond Bond No.
I15 C(t&STfr..WT
Legal Description Map No. Surety Company
1iict 20 (LOTS i'z. 4 24)
Subdivision Name Surety Address
Owner C3jIlZc4 t- J&SVIS CRIZIST Phone
cip LATrI1z-
Date Filed Rec'd by
Owner's Address Cash deposit Rec'd by x Date filed
Plans by '6i1=Eier 4YZ.C14-Ir&T R. C—
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The following documents are required and shall become a part
of the grading permit when they are approved.
___ Grading plans Specifications
______ Soil report Retaining Walls
Drainage structures _____ Other
Compaction report
Address r315 Ifl.L4 )Q-ruu PL Phone
Soil Engineer R.C.E. Phone
b1 c?Th41LTJ
Grading CoAtractor Phone
'1' -'--' F' C5 Or, X P Address R L
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
Party responsible for overall supervision Authorized hours of operation:
7:00 AM to 5:00 PM, Monday - Friday. Proposed use of grade site
Haul routes are to be approved by City Engineer.
Number of cubic yards
Cut Fill Import Waste Adequate provisions shall be made for erosion and siltation
control.
1 All slopes shall be planted per direction of Parks &
Recreation Director. Proposed Schedule of Start Finish
Operations (dates)
I hereby acknowledge that I have read the application 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. tl
_____ Signature of Permittee ________________________________________
Jr
Owner or authorized agent
All fills to be compacted to at least 90% of optimum
density unless noted otherwise.
• INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
ENVIRONMENTAL CLEARANCE -
Date
EIA Log No. g
By ''
Compaction report recd.
Planting & drainage
Final certification rec'd.
Grading permit fee $ / ... Work completed
Permit Issued Surety bond released
by _____________ Date 8 Copies: White-Office; Green-Building;
Permit Expiration Date 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