HomeMy WebLinkAboutPR 2.3.121; PALOMAR TECH CENTRE 2; Engineering ApplicationCITY O4ARLSBAD -- ENGINEERINGSEPARTMENT
APPLICATION
FOR ENGINEERING PLANCHECK OR PROCESSING
Complete all appropriate information. Write N/A when not applicable
PROJECT NAME: , TC, tL — 4-zcLJ 2- DATE_____________
PROJECT DESCRIPTION_
PROJECT ADDRESS: 245
104 ,
T NO().: .M*P NO.:iZ5 APN(S).:.
OWNER: APPLICANT:
Mailing Address: Z 3' 77 Mailing, Address:
Phone Number: (/1.9 ) 7 SI? //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 and correct-to the best of my knowledge.
Signature Date '7t2' Date 6
1
CIVIL ENGINEER: r-A. SOILS ENGINEER:___________________________
Firm: Firm:
Mailing Address: --- 7Z3 £. Mailing Address: ,7L/24__C4
- -- _- -
Phone Number: (_6/9)-_/—- Phone Number: (_--_-_-_-
State Registration Number: - / ('5 State Registration Number: -
LANDSCAPE ARCHITECT: COMMENTS: - _-
Firm: - - - - -
Mailing Address: - __-_ ------ -
Phone Number: - -_---
State Registration Number: -
- NO. OF DWELLING UNITS: ZONE: _- NO. OF LOTS: - NO. OF ACRES:,' i.f
IMPROVEMENT VALUATION: sewer, water & reclaimed water:- - -
Water District (circle one): Carlsbad Municipal Water District — Olivenhain Vallecitos
streets and drainage: - landscape: -
GRADING QUANTITIES':--'CY cut -- cy fill -'- cy
- - remedial cy import/export - - cy
PLEASE CHECK OFF APPLICATION TYPES ON REVERSE SIDE
1300CS\MISFORMSFRM00063 - REV 04128/95
Ank
FOR USE ONLY
Plancheck Type Drawing Project Deposit/Fees APPLICATION FOR
(CHECK ALL THAT APPLY): Number Number ID. - Paid
0 Adjustment Plat AMP
O Certificate of Compliance COC
of Easement ,'Dedication DOE.
'2,12 J 20C2 00
Type:
Type: S 0
O Encroachment Permit ENCROACH -
0 Engineering Standards Variance .ESV:.
O Final Map 0: FM
DGrading Plancheck 1GRPC
O Grading - :. GRADING
O Improvement Plancheck 0 Ipc
O Landscape Plancheck
O Parcel Map PM
O Quitclaim of Easement
Type:
Type:
O Reversion to Acreage RTA
O Street Vacation STV
O Tentative Parcel Map
o Certificate of Correction CCOR
O Covenant for Easement COVE
0 Substantial Conformance Exhibit SCE
APPLICATION ACCEPTED BY___________________
MASTER PROJECT ID________________________
RECEIPTNUMBER RECEIVED
PRELIMINARY SIERRA SYSTEM INPUT INITIAL 0 Nov? 5 199 SIERRA SYSTEM INPUT INITIAL
R:BASE INPUT INITIAL_____________ 0 VNOINFpRING
MASTER FILE NUMBER: F 0 DEPARTMENT
L:bther:_________________________________________
0
DATE STAMP
APPLICATION RECEIVED
P\DOCS\M(SFORMS\FRM00063 REV 04128/95