HomeMy WebLinkAboutPR 2.3.122; PALOMAR TECH CENTER 2; Engineering ApplicationCITY O•ARLSBAD - ENGJNEERINcEPARTMENT
APPLICATION
FOR ENGINEERING PLANCHECK OR PROCESSING
Complete all appropriate information. Write N/A when not applicable.
PROJECT NAME: i T % - 4c-J 2 DATE: 1//2 J,J
PROJECT DESCRIPTION: _
PROJECT ADDRESS: : 2.45(
Px / -
GT NO().: _2 .M*P NO.:,Z6$S APN(S).:-
OWNER* APPLICANT:
Mailing Address: Mailing Address:
92:3
Phone Number: (//9 ) 7,s'-? * ii 7 Phone Number: ( =
I certify that I am the legal, owner and that all the above information I certify that I em 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 thebest of my knowledge.
Signature Date Date ///2t.i7<9 6
CIVIL ENGINEER: ___ SOILS ENGINEER:__________________________
Firm: Firm: V
Mailing Address: 7 Z 3 iLi_4. 7t- /&t2 Mailing Address: c4.
-I -
Phone Number: ( é/9 ) - 4-/'- 47f- Phone Number:
State Registration Number: / 10.5' State Registration Number:
LANDSCAPE ARCHITECT: COMMENTS:_____________________
Firm:
Mailing Address:
Phone Number:
State Registration- Number:
NO. OF DWELLING UNITS: ZONE: OF LOTS:________ NO. OF ACRES:
IMPROVEMENT VALUATION sewer, water & reclaimed water:' ater
Water District (circle one): -QarIsbad Municipal Water District - Olivenhain Vallecitos
streets and drainage,
GRADING QUANTITIE 4 CY cut cy fill C 1
remedial cy import/export cy
PLEASE CHECK OFF APPLICATION TYPES ON REVERSE SIDE
P:\DOCS\MISFORMS\FRM00063 REV 04/28/95
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FOR CITY USE ONLY
Plancheck Type. Drawing Project Deposit/Fees APPLICATION FOR
(CHECK ALL THAT APPLY): Number . Number ID. Paid
D Adjustment Plat ADJP
O Certificate of Compliance
6Dedication of Easement
Type: .. ..i,..
DOE -
R2 , (z ;?C) 0, 00
Type: . .
O Encroachment Permit . . ... . ENCROACH
0 Engineering Standards Variance .
E. . .
O Final Map
[]Grading Plancheck . . . . GRPC
O Grading : GRADING
El Improvement Plancheck ...: IPC
O Landscape Plancheck . . LPG
O Parcel Map PM
O Quitclaim of Easement
Type:_______________________ . .. . S
Type:
U Reversion to Acreage : . RTA
O Street Vacation Sly
O Tentative Parcel Map . MS
o Certificate of Correction CCOR
O Covenant for Easement DOVE . .
O Substantial Conformance Exhibit SCE .
APPLICATION ACCEPTED BY___________________ . . . :. .
MASTER PROJECT ID RECEIVED : RECEIPTNUMBER___________________________
PRELIMINARY SIERRA SYSTEM INPUT INITIAL_______
SIERRA SYSTEM INPUT INITIAL_________________ . . .
R:BASE INPUT INITIAL ENGINEERING
DEPARTMENT
MASTER FILE NUMBER: F . . . .
Dother:_________________________________________
DATE STAMP
APPLICATION RECEIVED
P:\D0CS\MISFORMS\FRM00063 REV 04128/95