HomeMy WebLinkAboutPR 07-25; DOMINGUEZ RESIDENCE; Engineering ApplicationCITY'. CARLSBAD -ENGIN~ERING DePART..' it '
APPLICATION" '.' . '.'
PROJECT ADDRESS: l3Lf-Cr CyvlJ(ilk LVt.
LOT NO(S).: _____ MAP NO.: ______ APN(S).:
NUMBER OF LOTS: {
OWNER:
Mailing Address: I S{qS «)vtDW\&;' Ali.
Phone Number: l-=-.:r& 0)001 -'1S '5 fa 3
Fax Number: •
----~~--~--------~-r
E-Mail: ~D\M...\\~v\Q.7 etJdek~
I certify that I am the legal owner and thata'flithe above net-'
c ,rrect to the best of my knowled e.
CIVIL ENGINEER: -------------------------FIRM:
Mailing Address:
Phone Number:
Fax Number:
E-Mail:
State Registration Number:
NUMBER OF ACRES:
APPUCANT: '
Mailing Address:
Phone Number:
Fax Number: •
E-Mail:
Signature:
SOILS ENGINEER:
FIRM:
Mailing Address:
Phone Number:
Fax Number':
E-Mail:
State Registration Number:
IMPROVEMENT VALUATION
1. What water district is the proposed project located in? (check one)
Date:
DCarlsbad Municipal Water District DOlivenhain DValle¢itos
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) lancfscape and irri9ation, and drainage improvements
(if applicable)? $
GRADING QUANTITIES
cut ___ cy fill ___ cy remedial ____ cy import ___ cy export ___ cy
SEE REVERSE SIDE H:/DEVELOPMENT SERVICES/MASTERS/Application for Engineering Plan Check Revised 1114102
CI OFCARl$BAD -ENGINEERING DEWTMENT
. 'APPLICATION""
ENGINEERING, PLAN tHECK. -," , 'J',
Complete all appropriate information. Write N/A .when not applicable.
FOR CITY USE ONLY
APPLICATION FOR PROJEcr DRAWING i DEPOSIT/FEES : COMMENTS
( -/ all that apply) I~D. NUMBER' PAID ,
0 Adjustment Plat (ADJ)
0 Certificate of Compliance (CE)
0 Dedication of Easement (PR)
Type:
Typ~: ~e: rr Encorachment Permit (PR) rnDT-?~ ......
0 Final Map (FM) p •
0 Grading Plancheck (DWG) r,
" 0 Improvement Plancheck (DWG)
0 Parcel Map (PM) " ' ..
0 Quitclaim of Easement (PR)
Type:
Type:
Type:
0 Reversion to Acreage,(RA)
0 Street Vacation (STV)
0 Tentative Parcel Map (MS)
0 Certificate of Correction
(CCOR) ". , '.
0 Covenant of Easement (PR) . .. I . , "
0 Substantial Conformance
Exhibit (SCE)
!8) Other E-V\u~WlCU'\i ffiOft;(nX P-
/-lCCJ~~\
" , , , , : APPLICATION ACCEPTED BY;, .. . ' .. ,;' .. ' .
" ,,' , .. . ' " '
, DATE STAMP APPLICATON RECEIVED