HomeMy WebLinkAboutPE 2.9.21; CARLSBAD LANDS; Engineering ApplicationApplication for Grading Permi
PERMIT NO.-Z,,?,Z/
t (letter code + number)
CITY OF CARLSBAD Llot
PUBLIC WORKS & BUILDING DEPARTMENT Ssubdivision
1200 Elm Avenue C=City contract
729-1181 4Q -1 77 cc
FOR APPLICANT TO Fill IN
Site Address E/m ,4vc. Surety Bond Bond No.
Legal Description Map No.
f95 1661
Surety Company
Subdivision Name ai:/jaf ,Lo,vc1g Surety Address
Owner I Phone
T%ree_7Z9-373
Date Filed Rec'd by
Owner's Address
. c /499 ,-/kd Cash deposit Rec'd by Date filed
$
P lans by Civil Engineer R.0 E.
_,vXc/z___ ,455Oci/a/e_s
The following documents are required and shal
become a part of the grading permit when they
are approved.
Grading plans Specifications
_Soil report Vicinity map
Drainage structures Retaining walls
"-Compaction report Other
Address Phone
//z5 (i2Jn,Ai'c i2ef/2v si4;7Le (2. 2'/fl- Ca.
Soil Engineer R.C.E. Phone
Grading Contractor Phone
P4rkev 7 -2c
dd r ss 11 Check if supervised
T1V3JidL £Ve(4s grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
arty responsible for overall supervision
7P4- c'Aic7 C.1 I. Authorized hours of operation: 7:00 AM to
roposed
7
u of g9ade site
At rkwj
5:00 PM, Monday-Friday.
Haul routes are to be approved by City
Jumber 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 95 I I I of Parks & Recreation Director. Total
Compacted fills (yes or no)
Proposed Schedule of Stert Finish
Operations (dates) //.77 --77
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 agent iL
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report rec'd.
Planting & drainage
Final certification rec'd.
Grading permit fee $ Work completed
urety bond released
Permit Validation
by fcI Date i/-1-i
Permit Expiration Date c' -/ 77
THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD