HomeMy WebLinkAboutPE 2.9.28; LA COSTA SOUTH LOT 74; Engineering Applicationpplication for Grading Permits
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT NO. Z9 ~
(letter code + number)
Llot
S=subd iv is ion
C=City contract
77-Z'
FOR APPLICANT TO FILL IN
Site Address Surety Bond Bond No.
çPAI4 45000
Legal Description Map No. Id C 77 04 Surety Company
Subdivision Te Surety Address
Owner11 Date Filed Rec'd by
)wner s Add ress7j /7 Cash deposit Rec'd by Date filed
$
R.C.E. The following documents are required and shal
become a part of the grading permit when they
are approved.
?-Grading plans Specifications
SoiI report Vicinity map
Drainage structures Retaining walls
_Compac1-ion report _Other
Address Phone
Sc ,4A . S O WV e-2—
Soil Engineer Phone
-
Grading Cdntraci-or Phone
Address Check if sup ised SgA/v qradinq
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
'arty responsi4,or ov / supervision
-, I. Authorized hours of operation: 7:00 AM to
roposed use of grade site3.
'57 -'
5:00 PM, Monday-Friday.
Haul routes are to be approved by City
'umber of cubic yard:
Cut Fill Import Waste
Engineer.
Adequate provisions shall be made for
erosion and siltation control.
All slopes shall be planted per direction /7 I of Parks & Recreation Director. Total
77 Compacted fills (yp<or n,)
Proposed Schedule of F I DA sh-.
Operations (dates) 14(
I hereby acknowledge that I ve 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 $ Work completed
Surety bond released
Permit Validation
byt7U(. Date /a77
Permit Expiration Date ARef,Y 6/'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