HomeMy WebLinkAbout1704 ALGA RD; ; RW106530; Permit&
S • . I_••- 1-
DEVELOPMENT PROCESSING SERVICES DIVISION
2075 LAS PALMAS DRIVE
CARLSBAD, CA 92009-4859
(619) 438-1161
RIGHT OF WAY PERMIT
THIS PERMIT MUST BE
POSTED ON THE JOB SITE
Applicant Please Print and Fill In Shaded Area
JOB
ADDRESS /// /;i ki) ISSUED BY PATE
NEAREST / CROSS STREET I / )SA EXPIRES
PROJECT /c5 / NUMBER fA~ 24 HOUR NOTICE REQUIRED FOR
INSPECTION AND PRIOR TO START OF WORK. ASSESSOR'S PARCEL NO.
APN 47/'6 / ) CALL 438.3101
CONTRACTOR YOU MUST CALL UNDERGROUND SERVICE
ALERT (1-800-422-4133) TWO
WORKING DAYS PRIOR TO WORK. CONTRACTOR'S
MAILING
ADDRESS UNDERGROUND SERVICE ALERT NO.
)24 HOUR THIS PERMIT IS INVALID WITHOUT THIS NUMBER
CITY ZIP TEL.26 71 IF ANY EXCAVATION OR BORING IS DONE.
STATE BUSINESS
LICENSE LICENSE
NUMBER NUMBER
DESCRIPTION
OF WORK
VALIDATION AREA
INITIALS
TRAFFIC CONTROL PLAN APPROVED
AND ATTACHED
/ START
DATE
fr• Y LIABILITY INSURANCE VERIFIED ESTIMATED
COMPLETION DATE /L I J/ 1/
THE UNDERSIGNED ACKNOWLEDGES THAT ALL WORK PAID SHALL BE PERFORMED PER CITY CODES, STANDARD
SPECIFICATIONS, CITY APPROVED PLANS AND FEE: BILLED STANDARDS.
c
RESTORATION SECURITY 6111
SIGNATURE
DATE Jyl TRAFFIC CONTROL DEPOSIT
INSPECTOR'S
SIGNATURE DATE
BLUE - FILE; YELLOW - INSPECTOR; GREEN - UTILITIES; PINK - FINANCE; WHITE - CONTRACTOR -',-rm /