HomeMy WebLinkAboutPE 2.9.13; JACK WEST; Engineering ApplicationPERMIT NO.7 -$'73,
(letter code + number)
Llot
S=subd iv is ion
C=City contract
pplication for Grading PermitS
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
FOR APPI ICANT TO Fill IN
Site Address
/ 17 i'
Surety Bond 'IlL 12-77 3N****814.00
Legal Description Map No. Surety Company
Subdivision Name Surety Address
Owner Phone Date Filed Rec'd by
Owner's Address
2 ( C Cash deposit Rec'd by Date filed
$
'land by Civil Engineer
MIAA-sk become
R.C.E. The following documents are required and shal
a part of the grading permit when they
are approved.
Grading plans Specifications
Soil report Vicinity map
Drainage structures Retaining wails
Compaction report _Other
A ddress Phone
1,C& S74-r-ci f17 41Z(4',?4D 12-''-99/
Soil Engine r R.C.E. Phone'
Clcuck?rkec 74-.33
Grading Contractor Phone
Address Check if supervised
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
arty responsible for overall supervision
i 14', &ur,'i I. Authorized hours of operation: 7:00 AM to
róposed use of grade site
lumber
5:00 PM, Monday-Friday.
Haul routes are to be approved by City
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 217 217
of Parks & Recreation Director. Total
Compacted fi I Is (yes or no)
Proposed Schedule of Start
Operations (dates) #fOG 7,17
Finish
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 thppIi --
Signature of Permitteep i
Owner or authorized
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
- Rough grading
Compaction report
Planting & drainage
Final certification rec'd.
Grading permit fee $84 Work completed
.1 Surety bond released
Permit Vali ton
by Date 1L12
Permit Expiration Date VOP_'95R
THIS FORM WHEN PERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD