HomeMy WebLinkAboutPR 4.46; VISTA DEL MAR; Engineering Application• CITY OF CARLSBAD • . ENGINEERING DEPARTMENT ABOVE GROUND ENCROACHMENT PERMIT APPLICATION
I PR't-41.. I I PERM IT NO . .__c_B_9_0_1 _s_s 2 __ ---' PROJECT NAME .._ __ v_r_s_T_A_D_E_L_M_A_R _______ ~J _
LOCATION OF PROJECT: ON THE _E_a_s_t __ _.lsIDE OFI Carlsbad Blvd. I
(NORTH, SOUTH, EAST, WEST) (NAME OF ;S~~EEf)
BETWEEN f. Manzano AND Cerezo
(NAME OF STREET) (NAME OF STREET)
ASS ES SOR PARC EL NO ( S) . ,....--2-1 o-_-1_1_5_:._21--------------------.
BR! EF DESCRIPTION OF ENCROACHMENT: j street right of way
REASON FOR ENCROACHMENT:/ see encroachment agreement attached
OWNER APPLICANT
NAME (PRINT OR TYPE) NAME (PRINT OR TYPE}
Ray Escano Rav Escano
MAI LING ADDRESS MAILING ADDRESS
800 Grand Ave.Suite A-1 800 Grand Ave. Suite A-1
CITY AND STATE ZIP TELEPHONE CITY AND STATE ZIP TELEPHONE
. Car ls bad , Ca 92008 (619)720-10 )0 Carlsbad, CA 92008 f:619)720-10b
'I CERTIFY THAT I AM THE LEGAL OWNER ANO THAT I CERTIFY THAT-I AM THE OWNER'S REPRE-ALL THE ABOVE INFORMATION IS TRUE AND CORRECT SENTATIVE ANO THAT ALL THE ABOVE TO THE BEST OF MY KNOWLEDGE. INFORMATION IS TRUE AND CORRECT TO SIGNATURE DATE THE BEST OF MY KNOWLEDGE. SIGNATURE DATE
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~OR CITY USE ONLY
TOTAL FEE REQURIEDj ~"7),.oo
DATE FEE PAID I 6..:. /'1-Y ! . I
RECEIPT No. / ~fo? I
RECEIVED BY:
JUN 11 "1991
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