HomeMy WebLinkAboutPE 2.11.64; LA COSTA ESTATES NORTH LOT 13; Engineering ApplicationPERMIT NO.,I1(g (
(letter code + number)
Llot
S=subd ivis ion
C=City contract
Ap•ation for Grading Permit
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
FOR APPLICANT TO FILL IN
Site Address
CL),' 4 (.-/I-Cosi7
Surety Bond Bond No.
Leaal Description Ma No.
,i- I 3 L Co( eS7192:S ivoif
Surety Company
Subdivision"Name Surety Address
Owner Phone 7t€ i- y 4' 8/-1 '17 '/
Date Filed Rec'd by
Owner's Address
/'Y2- A/ - - 2j,JS so c
Cash deposit Rec'd by Date filed
$
Plans by Civil Engineer R.C.E.
S4-pf 211E60/7v
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
Box 3i7h-ET -Z$'-.3OV
Soil Engineer R.C.E. Phone
_~97 N6-. -7SZ2o6V
Grading Contractor Phone
L '9m' 7)
Address Check if supervised
/g2_,9.
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
Darty responsible for overall supervision
1L Cvc)c_iic,j I. Authorized hours of operation: 7:00 AM to
roposed use of grade site
-57i'C-L--e - ñvL'/ 7fc
5:00 PM, Monday-Friday.
Haul routes are to be approved by City
Number 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 ,,5-o I of Parks & Recreation Director. Total
Compacted fills (yes or no)
Ye5
Proposed cheduIe of Start Finish
Operations (dates) /i/ic/8O
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 regulating excavating and
grading, and the provisions and conditions of any
permit issued pursuant to this application.
Signature of Permittee___________________________
Owner or authorized
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report rec'd.
Planting & drainage
Final certification rec'd.
Grading permit fee $ c
Permit Validation
Work completed
I Surety bond released
by Date .1
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