Loading...
HomeMy WebLinkAboutPR 03-46; CHASE RESIDENCE; Engineering Application06/27/2003 02:40 7609441564 -----, ~N-27~2003 FRI 02:22 PM O~BAD ENGINEERING FAX NO. 760 ~052 PAGE 01 P, 01 cmOf~~~~:7.=:~,~:~P~~NT : .... ,.:.:. . .. .. . . . OJ'' . , t •••••• ,1 r.1' .. ~P·,' " ~·".:·I ... 't"" ',' •. , . . . ····M. EiiNG~ft~(dt ' '. '.. ' . ' . . . . . . E E . ' .. E!' ".' .. ,' .. , .. '.1 •••••. ' ' ••• ' .. cOmp'~ ali··~p.~prl~'.J"~~:~:!"'~Nl~'~.~~·a~.I~ . . ; j . . 'II. , .' .' ....... ~ ... PR03ECT NAME: c.,'c f\Si.... DATE: mi(p3 -• PROlecT DESClUP'TION: '~~g:ai& ~,Q"'''~ ~~. Dew" we~ ~.L. cert.. .... . .. ~ , bCltA. 9~ .. l !!,.I1lr~$ -:;r Ga.Se w .. • PROJECT ADDRESS: "31:1 l...dI.i ~(J ~ ~~ ld!:~~lJ! ~ gz..a2~ MAP NO.: APN(S).: , !.OT NO{S).: _ .. NUMBER. OF LOTS: ..... --.... NUMBER OF ACReS~ .. oWNSRI ~Q~IbISb..~ ~~~ APPlICAN'T: ~~~Pt(..Vltl~-/4t,:Ja.\j.' Mailing Address: ~ ?11 L"'-S B",·Sg, ~ Milling Address: ~):1;'ro,,.~ ~Q:;.:. . '7tt l.~ I ~dlo!"b:II~ s.,ua...L. kCD» eM qUee) s~'" DI~s ". ~ 9·trUe -pno"e Number: :J!.:zQ -~~~ .. 'S:~ Phone Number: , . tS8 --'S\.f.., .. t:(7.. " Fax Number': :2~.~" g~!:t .. IS ~Y.. Jl'axNumber: ~ <lJS~ ~ '5 to(.,. 1.(t.:r ~ E~MaIl: e-Mail: - '-that Itt 1he Jeo;d owner "",1Iiot '" ... ,1xMI '"formIaon ~~ • n i~best 01 my knoW~j' Signatult!J: 1 '/ DatelJ1,1 o.?J SIgnature: ~~ Dlte: Cltl:l(d CIVIL ENGINEeR: ~ SOILS ENGINEER: FIRM~ Pr~: . I -Manlng Address: Mailing Address: -.... .. ... Phone Number: Phone Number: -Fax NumDer. -Fax Number: ... -, I ... e-Mail: E"Mail: -'*' ~t~ Registration Numblr: .. stati! RegIStratIOn Number. II ADOmONA1. COMJV1ENTS; I -.......... . ---....." -.. I It -, -, .. --..... ~ IMPROVEMENT YALUAnON 1. What water distriCt IS the pro))QMd projtd: located.,7 (ched< one) OC&l'lSl*d MuniCipal W*t DIstrict OOIlVenh:ilfn DvaUec:ltos 2. If In the C.~d MunlClPilI Water DidfCt, what 1$ the total cost est:ImQte, including the 15% contingency fee, 1br 'W"" and ra.;lailMd wa .. , Improvements, _wet' (tor CerlltNtd Munld.,.. Water ~ only), street, pubfic (mediln) .. ndSalpe and 'rrlgation, Ind drainage IniproVWllHllltl (if apPlbbk!)? . $ I .... , GRADING QUAN'tlTI!S cut r:y fill _r;.'f remedial 0/ import cy expatt <;'f APPLICATION FOR ( -/ all that apply) o Adjustment Plat (ADJ) D. Certificate of Compliance (CE) o Dedication of Easement (PR) Type.:;...: ______ _ Type.:;...: _---:.. ____ _ Type: 0 Encorachment Permit (PR) 0 Final Map (FM) 0 Grading Plancheck (DWG) 0 Improvement Plancheck (DWG) 0 Parcel Map (PM) D Quitclaim of Easement (PR) Type: Type: Type: 0 Reversion to Acreage (RA) 0 Street Vacation (SIV)' 0 Tentative Parcel Map (MS) 0 Certificate of Correction (CCOR) 0 Covenant of Easement (PR) '0 Substantial Conformance Exhibit (SCE) D Other ~,~,,' "'-. ~ -- :~:i"~~~C;ATlO~' ACCEPTED BY:, '. " : ~'. ' .... -:.' , " ", . "', '~ .,~!,.! ~'-' ,.:', ~ , > -':;,.','-¥~'-" rvfl63.-tt ,:,~-~: -; i'i ~ ----"'~' '. H:lOEVELOPMENT SERVICES/MASTERS/Application for Engineering Plan Check Page 2 .. i , "~ ~ - Revised 1/14/02