HomeMy WebLinkAboutDEV 2016-0043; VAUGHN RESIDENCE; Engineering ApplicationCity of
Carlsbad
APPLICATION
GRADING PERMIT
E-24
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
I PERMIT NUMBER: (Z2Q1OO4O
Project Name: Vaughn Residence Project Number: DEV2016-0043
Project Location: 2605 Crest Drive, Carlsbad, CA. 92008 Drawing Number: 505-5A
Assessor Parcel Number(s): 156-152-29
Project Description: Construction of Single Family Residence
Owner: rcyan & ,.,)ue vaugnn
Address: P.O. Box 4415 Suite:
City: CARLSBAD State: CA Zip: 92018
Phone Number: (415) 420-5350 Fax Number:
I certify that I am the legal owner of this property and I authorize the grading associated with this permit.
OWNER SIGNATURE: DATE:
Civil Engineer: Daniel Valdez - Coffey Engineering
Address: 9666 Businesspark Ave Suite: STE 210
City: San Diego State: CA. Zip: 92131
Phone Number: (858) 831-0111 Fax Number: 030) OD HUI
Soils Engineer: Mark Hetherington - Hetherington Engineering
Address: 5365 Avenida Encinas, Suite A Suite:
City: Carlsbad, State: CA Zip: 92008
Phone Number: (760) 931-1917 Fax Number:
Grading Contractor: MKe.. L.Loy.k Em#t'. i,c. State License No.: __________________
City Business License No.: p$ It0%5
Address: . , l3o' (Sf Suite:
City: FAL4 Ntpak State: CA Zip: ¶O 1
Grading Quantities: cut 30 cy fill 30 cy import -0- cy
remedial 450 cy export -0- cy
Qualified contact person trained in NPDES requirements: Daniel Valdez - Coffey Engineering
Phone Number: (858) 831-0111
Basis of Permit Fees: cy Total Permit Fees: $
Verified By: Balance Due: $
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. I will also comply with OSHA
Permit requirements for trenches over five feet deep and the provisions and conditions of any permit issued pursuant to
this application.
Applicant Name: Ryan Vaughn
Address: P.O. Box 4415 Suite:
City: CARLSBAD State: CA Zip: 92018
Phone Number: (415)420-5350 Fax Number:
APPLICANT'S SIGNATURE: (flj....._- DATE: .
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RECEIVED
OCT 062017
LAND DEVELOPMENT
ENGINEERING
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