HomeMy WebLinkAboutCDP 2018-0002; MINICILLI ADU; Engineering Application4cco ty of
Cailsbad
APPLICATION
GRADING PERMIT
E-24
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
G-iztC- (3(S
I PERMIT NUMBER: I
Project Name:Acro_SSjrv &eIIIM yj Project Number: C09 zol'-coZ
Project Location: 3116 RU 31 Drawing Number:
Assessor Parcel Number(s): zo 3o-40-00
Project Description: NJI Von f A)1) I%-/ sii /y hc% C
Owner: i4 1,'t fib
Address: 39r2 1?i11&t je Suite:
City: C6 P 1C, bc / State: C14 Zip: gç
Phone Number: 'iy- ocgoqc) 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: AACIK
Address: 3q,Z6 HU WO Øjr_Q Suite:
City: (/j State: C/7 Zip: qZcxc
Phone Number: )) Fax Number:
Soils Engineer:
Address: )qç Suite: 3/)
City: Sol Wfjo State: C/ Zip:
Phone Number: 6 /,/J Fax Number: S- S'%-/Cyo
Grading Contractor: (.,. ç . State License No.: ID . 7 V31
City Business License No.:
Address: / C '/ (j.,))r 1 J-e Suite:
City: 1,'.A/frl) State: C. Zip: . c
Grading Quantities: cut 9g cy fill cy import C cy
remedial cy export C9 cy
Qualified contact person trained in NPDES requirements:
Phone Number:
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:
Address: 3J -f4J (,tI Suite:
City: (g1çJ,pd State: (ft Zip: ?~Q'
Phone Number: 505 - oO Fax Number:
APPLICANT'S SIGNATURE: DATE: /O-—/
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