HomeMy WebLinkAboutPR 4.75; WOODWARD ENCROACHMENT; Engineering ApplicationV
!!! CITY OCARLSBG S GPARTMENT , • 7r
FOR ENGINEERING. PLANCHECK OR PROCESSING
Comti/.t. a/I .øpropriat. vn'om,atah. Write N/A when not applicable.
PROJECT NAME: -P- DATE $-2O
PROJECT DESCRIPTIQN:
7P4f
PROJECT ADDRESS: 3'//3 t-1
LOT NO(S).: _/S MAP NO.:_/D/ APN(S):_ -4432
OWNER: IA) ifl (ADT4 APPLICANT:
Mailing Address: .//_2 i._iJtJ-L 4S7' Mailing Address:
Phone Number: I. é/' 4'3f 3c') /09 Phone Number: C.
I certify that! am the I. wner and that all the above I-certify that I am the agent of the legal ownerand that all informition
informatiOn is true c to the best of my knowledge. on tPñ Shalt is true and correct to the best of my knowledge.
Signt Date_ J2 Signature Date____________
CIVIL ENGINEER: SOILS ENGINEER:______________________________
Firm:
Firm:
Mailing Address: -
Mailing Address:
Phone Number: L -
Phone Number C
State Registration Numb.r
'State Registration Number: -. -
LANDSCAPE ARCHITECT: -ADDITIONAL COMMENTS:
Firm:
i/L C7
Mailing Address:
V + 7tJ /ftf 33rrj
Phone Number:
State Registration Nuf'.+
M. OF DWELLING UNITS: LFMP ZONE: NO. OF LOTS: + NO. OF ACRES:_____
IMPROVEMENT VALUATION: sewer, water & reclaimed water:____________________
streets and drainage: Iindscape: water -district. _________________
GRADING QUANTITIES:CY cut cy fill + cy
-remedial cv import/export cv
PLEASE CHECK OFF APPLICATION TYPES ON REVERSE SIDE
woCaMsFosMMoOo •- Page: 7 V ivilis3
CITY OF RLSBAD-ENGINEERING ARTMENT
• APPLICATION
FOR ENGINEERING PLANCHECK OR PROCESSING
Complete all appropriate information. Write N/A when not applicable.,
PROJECT NAME: .. DATE_______________
PROJECT DESCRIPTION: .
PROJECT ADDRESS:'. '
LOT NO(S).: MAP NO.: _' APN(S).:__________________________
OWNER: 'APPUCANT'
Mailing Address: Mailing Address:
Phone Number: ( Phone Number: ( -
'I certify that, I am the legal owner and that all the above information
is true and correct to the best 'of my knowledge.
I certify that I am the agent of the legal owner, and that all information on
this sheet is true and correct to the best of my knowledge.
Signature Date' Signature • Date____________
CIVIL ENGINEER: ', ' ' SOILS ENGINEER:____________________________
Firm: , ' Firm: •' '
Mailing Address: ' ._' Mailing Address: '
Phone Number: (_, 'Phone Number:
State Registration Number: ' , State Registration Number: '
'LANDSCAPE' ARCHITECT _, ADDITIONAL COMMENTS:____________________
Firm:
Mailing Address:
Phone Number:
State Registration Number:
-NO1 OF DWELLING UNITS: ' LFMP ZONE: ' 'NO. OF LOTS: ... NO. OF ACRES:_____
IMPROVEMENT VALUATION: sewer, water -& reclaimed water:__________________
streets and drainage: ' landscape:..'..,. water, district__________________
CY • GRADING QUANTITIES. ..' CV cut .-. .. cy' fill •__.
remedial - ' -••' • import/export ,: • cy
PLEASE CHECK OFF APPLICATION. TYPES ON REVERSE SIDE
P:\D0CS\MISF0RMSFRM00063 • . ' , ' 4 ' • ' - ' • REV 12/16/93