HomeMy WebLinkAboutPR 2.3.120; PALOMAR TECH CENTER 2; Engineering ApplicationCITY OFARLSBAD - ENGINEERINEPARTMEN1
APPLICATION
FOR ENGINEERING PLANCHECK OR PROCESSING
Complete all appropriate information. Write N/A when not applicable.
PROJECT NAME: ? 7'C, % 2 DATE: ///2 j-J9g
PROJECT DESCRIPTION: _4y Vf
PROJECT ADDRESS: 24 5) /c:21
P.tjX /
4OT NO().: 2 -MAP NO.: /z g55 APN(S).:________________________
OWNER: E97 APPLICANT:
Mailing Address: P __3' __77 Mailing Address:
1 9 ze,
Phone Number: C_/19_)_7 S"J _//J 7 Phone Number:
I certify that I am the legal, owner and that all the above information I certify that I am the agent of the legal owner and that all information on
is true and correct to the best of my knowledge. this sheet Is true apd corr to the best of my knowledge.
Signature —Date Signature 4/t _Date iiAr/i'
CIVIL ENGINEER: __, SOILS ENGINEER:___________________________
(-1
Firm: Firm: fl V
Mailing Address: 7Z3 -i2c-4' Mailing Address: C/I
Phone Number: ( 6'/9 ) 5/ Phone Number:
State Registration Number: /7 (5 State Registration Number:
LANDSCAPE ARCHITECT: COMMENTS:_____________________
Firm:
Mailing Address: -
Phone Number:
State Registration Number:
NO. OF DWELLING UNITS: ZONE: OF LOTS: OF ACRES: 45J
IMPROVEMENT VALUATION: sewer, water & reclaimed water:_____________
Water District (circle one): Carlsbad Municipal Water District '— Olivenhain Vallecitos
streets and drainage: landscape:
GRADING QUANTITIES: cut cy fill cy
remedial cy import/export - cy
PLEASE CHECK OFF APPLICATION TYPES ON REVERSE SIDE
P:\D0CS\MISFORMS\FRM00063 REV 04128/95
P:\DOcSNISORMS\FRM00063 REV 04128195