HomeMy WebLinkAboutSDP 80-03B; DANIEL'S CABLEVISION EXPANSION; Engineering ApplicationCITY OF CARLSBAD - ENGINEERING DEPARTMENT
APPLICATION
GRADING PERMIT
PROJECT NAME Q4k v,-'i PERMIT NUMBER: c,/'O/OO/°l
PROJECT LOCATION: 572c7 t/ 'iinc ,'ez/ z,/sro( A oc
ASSESSOR PARCEL NUMBER(S): 2 Q 9 - ç-/ - OS â cX?
PROJECT DESCRIPTION: ,4dd E-, 45c;s
OWNER:
ADDRESS:
PHONE NUMBER: (7Co) "-fl' 77441
I CERTIFY THAT I AM THE LEGAL OWNER OF THIS PROPERTY AND I AUTHORIZE THE GRADING
ASSOCIATED WITH THIS PERMIT.
OWNER SIGNATURE S DATE:
CIVIL ENGINEER: i
ADDRESS: /755 /i//,fP 4v4-&t $eeé 2oo, ó/-42 :4 93117
PHONE NUMBER:
SOILS ENGINEER:
ADDRESS: 5205 iC/1aJ> Jce' A1 czâ/rd1 C4 qo'
PHONE NUMBER: 762)â 911-79/7
GRADING CONTRACTOR: STATE LICENSE NO.:
ADDRESS: CITY BUSINESS LICENSE NO:
PHONE NUMBER:
BASIS OF PERMIT FEES: Scy
GRADING QUANTITIES: cy cut cy fill
cy remedial cy export/import
TOTAL PERMIT FEES: BALANCE DUE: VERIFIED BY:
I hereby acknowledge that I have read the application and information provided is correct. I agree to comply with all federal, state, and
city laws, ordinances, regulations and policies relating to excavation and grading including, but not limited to, the Federal Endangered
Species Act of 1973 and any amendments thereto. OSHA Permit requirements for trenches over five feet deep and the provisions and
conditions of any permit issued pursuant to this application.
APPLICANT NAME: PHONE NUMBER:
ADDRESS:
APPLICANT'S SIGNATURE: S DATE: S
WORD\DOCS'MISFORMSGRADING PERMIT APPLICATION
PROJECT REVIEW COMPLETION
EASEMENT and COVENANT FOR EASEMENT
The following project maps have been reviewed and are recommended for approval:
Project Name: eIs C o\V v Lcw
Project No.: tP S' C C F
Easement No.: P - 0 1 4 1
Sheets No.: Legal Description, c - sheet(s) (Exhibit "A) & Plat,I sheet(s) (Exhibit "B")
DECLARATION OF RESPONSIBLE CHARGE
I hereby declare that I have exercised responsible charge over the easement review of this project as
defined in Section 8703 of the Business and Professions Code to determine that the easements are
found to be in substantial compliance with applicable codes and standards.
Review of these project easements does not relieve the Land Surveyor or Engineer of Work of the
responsibilities with state and local ordinances.
Helming Engineering Co., Inc.
5962 La Place Court, Suite 245
Carlsbad, CA 92008
(760) 431-5999
Signed Date ;l 7JJ
Douglas L. Helming, RCE 23874
Expiration Date 12/31/01