HomeMy WebLinkAboutPE 2.9.15; WILSON INSUDTRIAL BLDS PARCEL 5; Engineering Applicationpplication for Grading Permiti
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT NO. 2? /IS--(letter code + number)
(lot
S=subd iv is ion
C=City contract
1 77 °7R**71 rfl
FOR APPLICANT TO Fill IN
Site Address Surety Bond Bond No.
Legal Description Map No.
A66 ' 1k
Surety Company
Subdivision Name Surety Address
Owner Phone Date Filed Rec'd by
Owner's Address
i5135-f&3 Cash deposit Rec'd by Date filed
$
Plans by Civil Engineer7 R.C.E.
,Wi4'Jk' 4/ ;t.'e. The following documents are required and shal
become a part of the grading permit when they
are approved.
?4 Grading plans Specifications
,Soil report Vicinity map
Drainage structures ,Retaining wal Is
Compact ion report Other
Address Phone V22 L614i,( L-
Soil Engineer R.C.E. Phone #
Grading Contractor Phone
Address Check if supervised
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
arty onsible for overal I supervision j I. Authorized hours of operation: 7:00 AM to
roposed use of grade 5t7
fr4t) a4i1ec_1
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 -
of Parks & Recreation Director. Total
(3-9,
o 7- - . - &7W
Compacted fills (yes or no)
V5
Proposed Schedule of Start Fi ni sh
A757 Operations (dates)
j.42-1...A2J2 ~]Alv ) 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 $ 7/2 Work completed
Surety bond released
Permit Validation
by Date /ZZ/7
Permit Expiration Date iz/zz/17
THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THISPERMITISVALIDFORASIX(6)MONTHPERIOD