HomeMy WebLinkAboutPR 03-89; SIMMERSON RESIDENCE; Engineering ApplicationPROJEa: DESCRIPTION: ,Cff)-l~"~, ~Jr¥.e.A---5>al)ec2
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P,ROJECT ADDRESS: ']rStt ~.I\e.,4' ~~~ W\.s\,tOA LA =t2.ac2'
LOT NO(S).: MAP NO.: _____ APN(S).: &8--~q/ -at
NUMBER OF LOTS: NUMBER OF ACRES:
OWNER:
Mailing Address:
Phone Number:'
Fax Number:
,E-Mail:
•
Mailing Address:
Phone Number:
7&(2-5 £;\J.eA--o..... AJ..If--
£"';\e... S"o\ SSe .. , Q\~ (?r:z.llk
]fSif 547-Ut'"L 72 '
Fax Number:
E-Mail:
I certify that I am the legal owner and that all the above
Inform'atlon Is true and coret to the. best of my knowledge.
Signature: ~rl;. ~"" . Date: (Q{25{<s3 Signature:
OVIL ENGINEER: _________ _ SOILS ENGINEER:
FIRM: FIRM:
Mailing Address: Mailing Address:
Phone Number: Phone Number:
Fax Number: Fax Number:
E-Mail: E-Mail:
0S'""r5 ~'+ 7 Lt 2.77
Date: to
/'
State Registration Number: State Registration Number:
ADDmONAL COMMENTS:
IMPROVEMENT VALUATION
1. What water district is the proposed project located in? (check one)
Dcarlsbad Municipal Water District DOlivenhain
RECEl"\lED
0(;1 3' 0 ,2803
DEPARTMENT
Dvallecitos
2. If in the Carlsbad Municipal Water District, what is the total cost estimate, including the 15%
contingency fee, for water and reclaimed water improvements, sewer (for Carlsbad Municipal
Water District only), street, public (median) landscape and irrigation, and drainage improvements
(if applicable)? $ ,
GRADING QUANTITIES
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cut ___ cy fill ___ cy remedial ___ cy import ___ cy export _---'-'-"'-cy ,
SEE REVERSE SIDE
H:JoeVELOPMENT SERVICES/MASTERS/Application for Engineering Plan Check Revised 1114102