HomeMy WebLinkAboutCDP 15-52; SCHMALTZ RESIDENCE; Engineering Application(City of
Carlsbad
APPLICATION
GRADING PERMIT
E-24
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
PERMIT NUMBER: GR 16-25
Project Name: Schmaltz Residence Project Number: CDP 15-52
Project Location: 6468 Franciscan Rd Drawing Number: 495-3A
Assessor Parcel Number(s): 214-023-04-00
Project Description: Minor grading of vacant lot for single family dwelling
Owner:
Address: 4 c jiçL Suite:
City: Cbç State: Zip: 9 20 I I
Phone Number: co7Q -rj3o3 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: 3*j.J.J\
Address: \')2f i5. Pr}r 4 Suite:
City: State: Zip: 612
Phone Number: - 35....Q Fax Number:
Soils Engineer: GreO C_.ø t:riC_,.
Address: ç,q (,tj fti3, p p . Suite:
City: _____ State: Zip:
Phone Number: Fax Number:
Grading Contractor: ('40 6 Pf State License No.: 100 3 245'
City Business License No.:
Address: (tZcGj-c4..J. '- Suite:
City: ______ State: Zip: 920i
Grading Quantities: cut cy fill cy import cy
remedial cy export cy
Qualified contact person trained in NPDES requirements: QA) tak v.t IA
Phone Number: _/ (.0 c7 - 12 I —
Basis of Permit Fees: 160 plus HMP cy Total Permit Fees: $ 845.20
Verified By: Kyrenne Chua Balance Due: $ 845.20
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: <R LIc , C - Suite:
City: cc45kl&A State: cc& Zip: q -o 11
Phone Number: — -o0 5 Fax Number:
APPLICANT'S SIGNATURE: DATE: JO fL
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Cop r - 52,
0061 - APPLICATION Development Services 4L City of ENGINEERING Land Development Engineering
Carlsbad PLANCHECK 1635 Fa ;aday Avenue
760-602-2750 E23 www.carlsbadca.gov
Complete all appropriate information. Write N/A when not applicable.
Project Name: 1,47 ,'51L544 Date: __T
Project Description: 4 ,t414/
Project Address: 7 Fi11-2',4/ ?kfr"
Lot No(s).:1 Map No.: _'2O/ APN(s):_________________________
Number of Lots: 1 Number of Acres: .,/1 Miles of Trails:_________________________
Owner: 1P,Li_J/1iT Applicant: cq,4 C>PVAf
Mailing Address: 3/?_ Mailing Address:
Phone Number: 7-c-._2V Phone Number:
Fax Number: Fax Number:
E-mail: E-mail:
I certify that I am the legal owner and that all the above
information i true and correct to the best of my knowledge.
Signature: _Date: _I -1t1 Signature:Date:
Civil Engineer: 1741' 1t _t'ié PkE Soils Engineer: 24.kØ"_i'.VEZfevt'
Firm: /I4I4 _c/Pl4h_W Firm: /A
Mailing Address: /ZZO > b/74iA)i_57 Mailing Address: G'60 ,'i4,hS_r,f - rC)-' _12) _C,4-zIF.
Phone Number: 29z_-721— Phone Number:
Fax Number: Fax Number:
E-mail: /)1ZA,JJ'._&/,'tIiAJt_.&41 E-mail:
State Registration Number: c1'_ State Registration Number:
Additional Comments:
IMPROVEMENT VALUATION
What water district is the proposed project located in? (check one)
Carlsbad Municipal Water District F1 Olivenhain El 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 UANTITIES
cut _______ cy fill cy remedial 16-0 cy import _______ cy export cy
E-23 Page 1 of 2 REV 07/14
APPLICATION Development Services City of ENGINEERING Land Development Engineering
06ff- icbd PLANCHECK 1635 Faraday Avenue
760-602-2750 E23 www.carlsbadca.gov
Comniete all anoronriate information. Write N/A when not anolicable.
APPLICATION FOR
(check all that apply)
FOR CITY USE ONLY
_________ Project
I.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 (STV)
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
El Other
APPLICATION ACCPTED BY: DATE STAMP
APPLICATION RECEIVED RECEIVED
JUN 272016
LAND DEVELOPMEN
ENGINEERING
E-23 Page 2 of 2 REV 07/14