HomeMy WebLinkAboutPE 2.9.17; MAEZEL LANE OAKLEY PARKER; Engineering ApplicationINSPECTION
Ground preparation
Rough grading
DATE INSPECTOR'S
SIGNATURE
Compaction report rec'd.
Planting & drainage
Final certification rec'd.
Work completed
T6
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*Application for Grading Permits
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT NO.Q.4L1
(letter code + number)
Llot
S=subd iv is ion
C=City contract
FOR FILL _APPLICANT _TO_ _IN
Site Address Surety Bond Bond No.
Legal Description Map No. Surety Company
Subdivision Name Surety Address
Owner Phone62IO Date Filed, Rec'd by O,9kL' 9sfAç'&i 295b 0.9er's Address Cash deposit Rec'd by Date filed
$
lans by Civil Engineer R.C.E. The following documents are required and shall
become a part of the grading
are approved.
permit when they
Address Phone
plans
Soil report
Tfications
-9Tity map Soil Engineer R.C.E. Phone
S, Q,, 7r,'1ij c?4? . ge structures
action report
Retaining walls
Other Grading Contractor Phone
ddress Check if supervised SPECIAL CONDITIONS WHICH ARE MADE
I grading A PART OF THIS PERMIT
party responsible for overall supervision
Authorized hours of oDeration: 7:00 AM to
roposed use of grade site
umber of cubic Ards /
Cut Fill Import Wa
oI?e'2I I
ota I
Compacted fills or no)
Proposed Schedule of Start Finish
Operations (dates)
I hereby acknowledge that I have read the applica-
tion and state that the information I have providec
is correct and agree to comply with all City
ordinances and State laws regulating excovaling anc
grading, and the provisi an condi •ons of any
permit issued pursuan o i ,p,Yati9
ignature of Permi--e,
ner or authorized agent
- 5:00 PM, Monday-Friday.
2.Haul routes are tobe approved byCity
Engineer.
3.Adequateprovisionsshallbemadefor
erosion and siltation control.
4. All slopes shall be planted Der direction
of Parks & Recreation Director.
Grading permit fee $
Surety bond released
mit Va~idgtjon Fer
,tj/Date
Permit Expiration Date / _
THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THISPERMITISVALIDFORASIX(6)MONTHPERIOD