HomeMy WebLinkAboutPD 2019-0009; WEBSTER RESIDENCE; Engineering Application,-. ----------------------------
{cityof
Carlsbad
APPLICATION
GRADING PERMIT
E-24
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
I PERMIT NUMBER: GbtP\ -Col p
Project Name: WEBSTER Project Number: PD2019-0009
Project Location: 2ZQQ ABGOt::.IAUIA Drawing Number: 517-6A
Assessor Parcel Number(s): 215-460-05-00
Project Description: GR~nlNG i=nR NEW Rl=~lni=Nr.i=
Owner: Chief Mountain Holdings
Address: 1460 ORPHEUS AVENUE Suite:
City: ENCINITAS State: CA Zip: 92009
Phone Number: 702.296. 7883 Fax Number: N/A
I certify that I am the lega~~!_t~_ispropertyan<:lJ.:~orize the grading associated with ~hi permit.
OWNER SIGNATURE:-~'·' ===1 --·~···~·-DATE: ~\;;?oz.o
Civil Engineer: STEVEN NORRIS
Address: 2121 MONTIEL ROAD Suite:
City: SAN MARCOS State: CA Zip: 92069
Phone Number: 760.839.7302 Fax Number:
Soils Engineer: ERIN RIST
Address: 2121 MONTIEL ROAD Suite:
City: SAN MARCOS State: CA Zip: 92069
Phone Number: 760.839. 7302 Fax Number:
Grading Contractor: X. iJ Bu-, l/1. -r /;{.,../oD/v?.f.._;r-State License No.: t:}Jn2tfJ
7t,o-\J ,, City Business License No.: I ~ I
Address: L'1.ftt.'5J O[al.,l,,C,. ~ 11 J.e Suite:
City: ?'t:1. t•iau
I State: t'# Zip: C/z.021/ tA 6
Grading Quantities: cut 17d cy fill li.?o cy import /$uO cy
remedial cy export f.P cy
Qualified contact person trained in NPDES requirements: J( -.'i't ,~J. ~'('It,
Phone Number: 7d2 -:) 1J {,-7~:i'i.3
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: KEITH WEBSTER
Address: Suite:
City: ~ State: Zip:
Phone Number: ~ /. ~ Fax Number: _, ,,,.,....,., \
APPLICANT'S SIGNATURE.,-1 . .1 =---·-·· -··-···-~-~ ···~ DATE: ~~zow ........ .
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