HomeMy WebLinkAboutPE 2.7.6; CARLSBAD LANDS; Engineering ApplicationPERMIT NO.2 -
(letter code + number)
LIot
S=subd iv is ion
C=City contract
- Opplication for Grading Permits
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
FOR APPI ICANT TO Fill IN
Site Address
j7c/ $;,q9D
Surety Bond Bond No.
Legal Description Map No/Wl'7cZ3
7R4cr 9 7oc C4cai) ow D-~ Scr ,
Surety Company
Subdivision Name Surety Address
)wner, Phone h'I
DateFiled Rec'd by
Owner's Address
,_5<oc- EL C,c')o& th-vb
Cash deposit Rec'd by Date filed
$
Plans by Civil Engineer R.C.E.
ELI_/oTT ,11,i19 The following documents are required and shal
become a part of the grading permit when they
arepoved.
Po Grad plans S cifications
Soil report Iinity map
Dr inage structures Retaining walls
kpaction report Other
-
Address Phone 74O Uf'JiVSQ.,iT ,4VE. 4&!S —0554—
Soil Engineer R.C.E. Phone
aim LiKik!& /7030 2fz -5/op
Grading Conractor Phone
£/. L10E7 7/Y-5 c73s6'3
Address Check if supervised
grading fr
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
'arty responsible for overall supervision
/LI,4ifY1CO 2E7UC I. Authorized hours of operation: 7:00 AM to
'roposed use of grade site
7/2/,v/.c C'2T 5:00 PM, Monday-Friday.
Haul routes are to be approved by City
lumber of cubic yards
Cut Fill Import Waste
ngineer.
Adequate provisions shall be made for
erosion and siltation control..
All slopes shall be planted per direction d 4 /'/Oyn /'/S2C4yDI 30r, yb.
of Parks & Recreation Director. Total
Compacted fills or no)
Proposed Schedule of Start Finish
Operations (dates) 42/I9'is- W-'1 15
I hereby acknowledge that I have read the applica-
tion 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 t i pplication. .
Signature of Permittee
Owner or authorized agent
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report rec'd.
Planting & drainage
Final certification
Grading permit fee 84.00 (Paid)
Work completed
Surety bond released
Permit V V lion
b y &~ DateA,9
Permit Expiration Date
THIS FORM WHEN PROPERLY VAL(DATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD