HomeMy WebLinkAboutPR 4.54; FAIRWAYS; Engineering ApplicationA CITY OF CARLSBAD ra • ENGINEERING DEPARTM~NT 'W ABOVE GROUND _ENCROACHMENT PERMIT APPLICATION
PERMIT NO., rt~ s~ I PROJECT NAME! ;:;,114t/A'f$ e, /, fo -z~
lOCATION OF PROJECT: ON THE I ~un,/ I SIDE OF/ Cb/11.?'IJS._ Pl£ LA '451i4 1
(NORTH, SOUTH, EAST, WEST) (NAME OF STREET)
(NAME OF STREET) (NAME OF STREET)
ASS ES SOR PARCEL NO ( S) . ,r-: _Z._/_b ___ /._'3_D ___ 6 __ /:-------------__,
BR'iEF DESCRIPTION OF ENCROACHMENT: a,111~e.er Sreet-~/f/~E
REASON FOR ENCROACHMENT, # C,,u~r/f2V~, EAJrJt2
OWNER APPLICANT
NAME (PRINT OR TYPE) a NAME (PRINT OR TYPE) 7Ne Pet,,t;,.!!Sn>AI'~ ~" ~Ml&
CITY ANO STATE /1 ZIP/2 TELEPHONE CITY AND STATE
'N .P1et§tJ f-'A t/Zlll ("6/9.. ~t/i>-$1)8 .
ZIP TELEPHONE
********************************************************** *
FOR CITY USE ONLY -
·,.,....-.:·-,,!:lOJ.AL FEE REQURIEO-, ,---50--ttE-----.
· • · r,v-,,--.[)ATE FEE PAID I *71 .,
·RECEIVED
/~AN 081992
RECEIPT NO. I tLfL I
RECEIVED BY:
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