HomeMy WebLinkAboutPD 15-10; THE LO RESIDENCE; Engineering Application0-
(Cityof
Carlsbad
APPLICATION
ENGINEERING
PLANCHECK
E-23
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
Complete all appropriate information. Write N/A when not aoolicable
Project Name:.-R( . Lo gtJ idQflC( - Date:___________________________
Project Description: 6rD4II P.ii r Sir\.t *sj(,j Lsidvie,Q
Project Address: 737-5 W,tIo 9ruk
Lot No(s).:4i Map No.:1'$0 APN(s):ZtZ5OO7
Number of Lots: Number of Acres: 0. 01 Miles of Trails:_____________________
Owner: Pt.k( t SvLPAN Lo Applicant:
Mailing Address: Ii1t i4. °k SrctLk Mailing Address: ___________________________
XoV'U/4k/PrZ. B5Z(oO CA S
Phone Number: g2.O (o51 - Phone Number:
Fax Number: ________ Fax Number:
E-mail: bb3tWU. Q E-mail:
I certify that I am the legal owner and that all the above
information is true and correct to the best of my knowledge.
Signature: % Date: /t/Z r1t~ Signature: Date:
Civil Engineer: C. Soils Engineer: Ma1Jt ii&
Firm: FArkeweA&M FrAi ttewø Firm: E,to4tç varAwhiamAti.\v\C.
Mailing Address: '3kb W.. Mailing Address: S. e,c4 F
50 $cas CA 9holl 5kiA 1AILrea. CA 92..01
Phone Number: HgO- 10 -'I2 (
Phone Number: -he o- 7(,L ol ON
Fax Number: 1110 510 vaSjo Fax Number:
E-mail: Aom @ rCZSA.CM'l E-mail: etAS!a______________
State Registration Number: )1Z..(p State Registration Number:
Additional Comments:
IMPROVEMENT VALUATION
What water district is the proposed project located in? (check one)
Xcarlsbad Municipal Water District fl Olivenhain E Vallecitos
If in the Carlsbad Municipal Water District, what is the total cost estimate, including the 15% contingency fee, for
water and reclaimed water improvements, sewer (for Carlsbad Municipal Water District only), street, public
(median) landscape and irrigation, and drainage improvements (if applicable)? $
GRADING QUANTITIES
fill cutJA cy cy remedial cy import _______ cy export
I'dOO 327
E-23 Page 1 of 2 REV 07/14
PO o-1 0
(
tL
City of
Carlsbad.
APPLICATION
ENGINEERING
PLANCHECK
E-23
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
Complete all appropriate information. Write N/A when not applicable.
APPLICATION FOR
(check all that apply)
FOR CITY USE ONLY
Project
1. D.
Drawing
Number
Deposit /Fees
Paid
Comments
El Adjustment Plat (ADJ)
El Certificate of Compliance (CE).
El Dedication of Easement (PR)
Type:
Type:
El Encroachment Permit (PR)
El Final Map (FM)
Grading Plancheck (DWG)
El Improvement Plancheck (DWG)
El Parcel Map (PM)
El Quitclaim of Easement (PR)
Type:
El Reversion to Acreage (RA)
El Street Vacation (SW)
El Tentative Parcel Map (MS)
El Certificate of Correction (CCOR)
El Covenant of Easement (PR)
El Substantial Conformance
Exhibit (SCE)
El Trails El <mile El > mile
I'Other Pip
APPLICATION ACCEPTED BY:
K (
c
DATE STAMP
APPLICATION RECEIVED
OCT 2'8 ?05
E-23 Page 2 of 2 REV 07/14
c(cityof
Carlsbad
APPLICATION
GRADING PERMIT
E-24
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
PERMIT NUMBER: GR 16-30
Project Name: Lo Residence Project Number: PD 15-10
Project Location: 3325 Venado St Drawing Number: 490-1A
Assessor Parcel Number(s): 223-250-07-00
Project Description: Development of a vacant lot into a 2700 S.F. single family residence with attached garage
Owner: 'Y4LV4 )Øvl A.
Address: __ Suite: _______________
City: ___ State: Zip:
_________
Phone Number: 400 — 6 i f3 Lf 0 Fax Number:
I certify that I am the legal owc the grading associated with this permit.
DATE:
Civil Engineer: 1Zi\ c1fi
Address: Suite:
tate:
1'M
Zip: O19 City: c{11A 'AAkAJ1!.M _
Phone Number: "7 ) — (f — 57_- __________
Fax Number:
Soils Engineer: M5 itO+4A.i14 ô
Address: Suite: (12 cj
City:
.1___ ____0
State: Zip:
Phone Number: I (,O — Z Fax Number:
Grading Contractor: State License No.:
City Business License No.:
Address: Suite:
City: State: Zip: __________________
Grading Quantities: cut (O Q cy fill Z...IOc cy import — cy
remedial 1 0 50 cy export Z_ b 0 cy
Qualified contact person trained in NPDES requirements:
Phone Number:
Basis of Permit Fees: 3850 plus HMP cy Total Permit Fees: $ 21582.66
Verified By: Kyrenne Chua Balance Due: $ 21582.66
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:
Address: Suite: _____________________
City: _ State: zip: e c6ô ____________________ __________________ _________________ ___________________ ___
Phone Number: tj.... 6 5' Fax Number:
1Tt1GNATURE: ., DATE:
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