HomeMy WebLinkAboutPE 2.89.13; GORGUEIRO RESIDENCE; Engineering ApplicationApplication for Grading Permit PE No.
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
2075 Las Palmas Drive' Validation by Finance
Department
881685
Building Permit Plan Check No,.
FOR APPLICANT-TO FILL IN
Site Address Surety Company Bond. No.*
3880 Althea.Lane C'arlsba*d, CA 92008
Eti?2 0 - 6.5 Map No. Surety..Add.ress
Subdivision Name Date Filed*- Rec'd by
Owner Phone
-hoe 670.6 Kenneth & Cathy DOn'a _43~4 Cash deposit -Recd by Date filed
$
Owner's Address The following documents are required. and shall become a'part
3969 Park Jr. Car.1sbad, C_A~ 92003 of the grading permitwhen they areapproved.
-Plans by Civil Engineer R..C,. E.
San Dieguito Engineering Grading plans Specifications
Soil report Geologic RepoO Addrew Phone
an ch e~ Fnc,initas 753-55,75 .4407 H ster Drainage structures Other
Compaction report Soil. Engineer A.C.E. Phone
Grading Contractor Phone SPECIAL CONDITIONS WHICH ARE-MADE
A PART OF THIS PERMI T
Address 1 . Authorized hours of operation,:,.
7*00 AM* to Sunset, Monday - Friday.
-Party responsible for overall supervision
-2. Haul routes are to be approved, by City Engineer. Proposed use, o f grade:site
Adequate provisions shall be made for erosion and siltation
contro
-
I.- -Number of cubic yards
Cut Fill Import Waste All slopes shall be planted per City Code.'-
.5 ASO.
Proposed, Schedule. of Start Finish All fills to be compacted to atleast 90% of optimum
Operations (dates) density unless noted.. otherwi se.
1 1kereby acknowledge that I have read the application and state that
the information I have provided is correctand agree to complyWith
-laws re al I City ordinances and~ State gulating.excavating and grading, - Under City Code Set. 11-.06 170 th IS
lei: and the provisions and conditions of any permit issued pursuant to ..0 REGULAR GRADING.- City inspector will make Inspections,-.
this application. listed below. - -
E3 CONTR - OLLED GRADING - Private grading engineer shall
Signature of Permittee observe work,, coordinate tests, Make reports.
k9yL"4-4i~, INSPECTION DATE 'INSP. SIGNATURE
Owner or autho.tized agen,
~nitlel - site prep.-
ENVIRONMENTAL CLEARANCE -
Date~ pri r to drains Rough 0
EIA Log No. Final - slopes planted
By
Compaction reports rec'd. Grading permit fee $ Plan check fee OC),
Privato.angr. cert.. rec'd. Permit Issued
by Date White-Office; Green-Building;
Permit Expiration Date. Yellbw-jinspedtor; 'Pink-Permittee; 'Goldenrod-Fina.nce
THIS FORM-WHEN PROPERLY VALIDATED, IS A PERMIT TO DO THE WORKDESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD
CITY ORARLSBAD -ENGINEERING OEPARTMENT
APPLICATION
GRADING PERMIT
PROJECT NAME: Cnoa& L)L=1 PO &&f2th&A-?e_S, PERMIT NUMBER:
PROJECT LOCATION: 1ALZrI46A. LAAAE-5
ASSESSOR PARCEL NUMBER(S): -7 -~- I ZD
PROJECT DESCRIPTION: GP_s11,bjA;)&. 40r- sj**t~ Act- A- 91,*j(eW&-Fy"&Le
OWNER: aus /AID66 6046US(PO
ADDRESS: 2~70% LAM16rlg, c6g"dtft -4,4 !27_66 8
PHONE NUMBER: - 7 2P) - 04015
I CER11FY THAT I AM THE LEGAL OWNER OF THIS PROPERTY AND I AUTHORIZE THE GRADING ASSOCIATED
WITH THIS PERMIT.
OWNER SIGNATURE DATE: is M3
CIVIL ENGINEER: rescrALV iA*_A5_AiA)i6 - MAA~r&~ 19, t-4o4A* *446pllf
ADDRESS: 146-1 A4 tO t S*n& 6A..#e- tvi' r-A 4) 20r_4
PHONE NUMBER: "79'1
SOILS ENGINEER: --JOHIO V99AVA) A"00,647%( t4L/&_~10j-iAVr A"lVdA&
ADDRESS: aseAwht to cA
PHONE NUMBER: -Rfaba
GRADING CONTRACTOR: STATE LICENSE NO.:
ADDRESS: CITY BUSINESS LICENSE NO:
PHONE NUMBER:
BASIS OF PERMIT FEES: cy
GRADING QUANTITIES: cy cut 324 cy fill P_ sm ev remedial cy eximWimport
PtMwl'T aq5l VERIFIEPj
,
TOTAL PERMIT FEES: BALANCE DUE: BY:
1. hereby acknowledge that I have read the application and information provided is correct. I agreq toM
comply with all City ordinances and state laws relating to excavating and grading, including OSHA permit
requirements for trenches over five (5) feet, and the provisions and conditions of any permit issued
-pursuant to this application.
APPLICANT NAME hdd&tfiE4= & )4 PHONE NO. 7-T3-67r0
ADDRESS: A(6,y Ad. IW4~ tot$ srd &AXIAXT".1 CA - 6170"
APPLICANT'S SIGNATURE: DATE:
P:\D0CS\M1SF0RMS\FRM00065 REV. 03/08/93