HomeMy WebLinkAboutPR 4.50; SPRING RESIDENCE; Engineering ApplicationA CITY OF CARLSBAD • _, ENGINEERING DEPARTMENT
ABOVE GROUND ENCROACHMENT PERMIT APPLICATION
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. PERMIT NO. [ :PR4 .50 I PROJECT NAME! ~tf,~95 14,~
LOCATI-ON OF PROJECT: ON THE l /Uo/Z-/{ jsIDE oFjr-_'i3_;r/-_SS_e.<,J_()_90--tfu-c------,
(NORTH, SOUTH, EAST, WEST} (NAME OF STREET)
snwE EN I ti ~11 tJ!:L AND -._I __ ;U_-l7 __ -e"_ze=· ---..:.J/i.....-------.J
-(NAHf OF STREET) (NAME OF STREET)
ASSESSOR PARCEL NO(S).j ;;..os --CJ{?Q _ -~ -2>7
BRIEF DESCRIPTION OF ENCROACHMENT:
REASON FOR ENCROACHMENT: h_~
CITY AND/ STATE
CA-f"Z.sh
OWNER
ZIP
C/zoo
·NAME
APPLICANT
(PRI~ OR TYPE-~~--
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MA IL I1NG ADDRESS
ZIP TELEPHONE
I CERTIFY THAT I AM THE LEGAL OWNER AND THAT I CERTIFY THAT I AM THE OWNER'S REPRE-. ALL THE ABOVE INFORMATION IS TRUE ANO CORRECT SENTATIVE ANO THAT ALL THE ABOVE TOTE BEST OF MY KNOWLEDGE. INFORMATION IS TRUE AND CORRECT TO S' ATU E DATE/'? 6 THE BEST OF MY KNOWLEDGE. 7~,;27-l,SIGNATURE DATE
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FOR CITY USE ONLY
TOTAL FEE REQURIE0-, .... -62,_tJ_tf?-___ _
DATE FEE PAIDltf-vr (?'I
RECEIPT NO. I 8398
RECEIVED BY:
. -.. -..
OCT 211991
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