HomeMy WebLinkAboutADJ 05-06; VANHORN ADJUSTMENT; Engineering ApplicationCr *F CARLSBAD - ENGINEERING DEPANT
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APP, ucAuON
ENGINEERING PLAN CHECK
Complte all appropnate !flfOrmatlorl Write N/A when not applicable
MOP
PROJECT NAME: DATE: Y/ /O
PROJECT,DESCRIPTI,N: i\- ø'LO V / O1-42 ~01Q
PROJECT ADDRESS: 0 9 r /, C'q
LOT NO(S).: j L'-.. MAP NO.: 'APN(S).:
NUMBER OF LOTS: NUMBER OF ACRES:
OWNER: 1Qt'ty \/y1, )9 APPLICANT:
Mailing Address: '7 /c/ co 4i c+ Mailing Address:
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Phone Number: -O Phone Number:
Fax Number: c.3 - -é 3 Fax Number:
E-Mail: /r-V/W#VOI?/'c! 4ot' E-Mail:
I certify that I am the legal owner and tat all the above
Information is t e a d co rr to the b st of my knowle ge.
Signature ,
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Date: Signature: Date:
CIVIL ENGINEER. 4' '''t /Jj SOILS ENGINEER..
FIRM: JN P ciq-/c1 FIRM:
Mailing Address: 1 8 5 9ii ,iddic-r 7/'( Mailing Address:
4aq ~2;qp c::i7
Phone Number: 411 - Phone Number:
Fax Number: Fax Number:
E-Mail: E-Mail:
State Registration Number: State Registration Number:
ADDITIONAL COMMENTS:
IMPROVEMENT VALUATION
What water district is the proposed project located in? (check one)
[]Carisbad Municipal Water District DOlivenhain UVallecitos
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
cut _______ cy fill _______ cy remedial cy import cy export cy
SEE REVERSE SIDE £\PJ C6.cL9 ft/DEVELOPMENT SERVICES/MASTERS/Application for Engineering Plan Check I Revised 1/14/02
RECEIVED
APR 28 2005
ENGINEERING
DEPARTMENT