HomeMy WebLinkAboutPE 2.92.23; SHELLEY PROPERTY STOCKPILE; Engineering ApplicationRECEIVED
CITY OF C RLSBAD - ENGINEERING DRTMENT
APPLICATION .VAR 4
GRADING PERMIT P. AI
PROJECT NAME: U. S. D. StkL k PERMIT NUMBE!'1GINEERINGCOUNTE
PROJECT LOCATION. t
ASSESSOR PARCEL NUMBER(S): a6 q I 0 ii
PROJECT DESCRIPTION:
xy o\iv4a Ctr)-,
OWNER:. Dant T S
ADDRESS: c105 \jv C-j . oaq
PHONE NUMBER: 753 _____..
I CERTIFY THAT I AM THE LEGAL OWNER OF THIS PROPERTY AND I AUTHORIZE THE GRADING ASSOCIATED
WITH THIS PERMIT. S
OWNER SIGNATURE (1iL.1 7T ' DATE: - ?3
CIVIL ENGINEER:
ADDRESS:
PHONE NUMBER: 131 -
SOILS ENGINEER:SoLftrh CX S0.\ ' TQ$J%M _S0,A5
ADDRESS: 6 R..rL-L St S D&e. CA 9212.Q
PHONE NUMBER:
GRADING CONTRACTOR: __'vt- ç\Ltc-s._E_Lk-iC STATE LICENSE NO.:3 I75 )-'
ADDRESS:E' 1d/( '1O6'S S(&LM ' CITY BUSINESS LICENSE NO:______________
PHONE NUMBER: -711 5GI 5-
BASIS OF PERMIT FEES: 'Z- .5O cy
GRADING QUANTmES: cy cut _Z130 , .jVt cy fill
- cy remedial .._L— cy exportlimport
VERIFIED
TOTAL PERMIT FEES: BALANCE DUE: , '+ BY:
I hereby acknowledge that I have read the application and state that the information I have provided is.
correct and agree to comply with all City ordinances and State Laws requiring excavating and grading, and
the provisions and conditions of any permit issued pursuant to this application.
APPLICANT NAME
53 -Sq0 PHONE NO._7
ADDRESS: . 105 O\t.t- Cr-ft
APPLICANT'S. SIGNATURE: - DATE: 3-3-7
'P:\DOCS\MISFORMS7RM00065 7 REV. 01/11/93