HomeMy WebLinkAboutPE 2.9.31; RANCHO AGUA HEDIONDA PARCEL 3; Engineering Application01 U 1P jq1
pplication for Grading Permits
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1181
PERMIT NO._________
(letter code + number)
Llot
S=subd ivis ion
C=City contract
FOR APPI ICANT TO Fill IN
SiteAddress . Surety Bond OCT 1477 cc fti:15.UU AJo-
Leaal Des IC-uri tN Ma o\
M . .
Su L4.jvision Nam
Surety Company
xcX P\\Ao\ -c\%ck
Surety Address
) w Phone \ Date Filed Rec'd by
Er$ Cash deposit Rec'd by Date filed
$
lans.b'j Civil Engneer R The following documents are required and shal
become a part of the grading permit when they
a re approved.
_Grading plans _Specifications
Soil report Vicinity map
Drainage structures Retaining walls
Compact ion report _Other
ddres Pho
Soil Engin.eer R C E
_
;rading Cont ct Phone
kr*
Address Check if supeJed
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
MntyrespoJpIe for ovec&II supervi ci on
____________________________ I. Authorized hours of operation: 7:00 AM to
grade site 5:00 PM, Monday-Friday.
Haul routes are to be approved by City
lumber o cubic yards
Cut Fill Import Waste
Engineer.
Adequate provisions shall be made for
erosion and siltation control.
All slopes shall be planted per direction '6D 44t ( of Parks & Recreation Director. rota c\3
FOk.. c!aP /41 Compacted fi I I! (yes or no)
7— 15, O Proposed 5chedule of fliS
Operations (dates)
/ / I hereby acknowledge that I / have read the plica-
tion and state that the information I have providec
is correct and agree to comply with all City
ordinances and State laws regulating excavating anc
grading, and the provisions and conditions of any
permit issued pursuant to this application.
Signature of Permittee
Owner or authorized agent_________
- INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Compaction report rec'd.
Planting & drainage
ina certification rec'd.
Grading permit fee $ Work completed
I Surety bond released
Permit Validation
by Date/O/'-7
Permit Expiration Date __/4 _/'77
THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THISPERMITISVALIDFORASIX(6)MONTHPERIOD