HomeMy WebLinkAboutCUP 2018-0014; CARLSBAD FIRE STATION NO. 2; Engineering ApplicationtF . f APPLICATION '-City O GRADING PERMIT
Carls~EIVED E-24
Development Services
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www.carlsbadca.gov
··-L i I I PERMIT NUMBER: l'J KL() i.-i -{,;{_? i r.,, c11.,,,-..,,_,,,....,.. ..... , .. -
LAND DEVE' OPMENT
Project Name: Carisbaa~ire 'sfalroli' Nb~ Project Number: CUP2018-0014
Project Location: 1906 Arenal Road Carlsbad, CA 92009 Drawing Number: 530-SA
Assessor Parcel Number(s): 215-140-1900
Project Description: Demolition of existing fire station for construction of new and modernized fire station.
Owner: City of Carlsbad
Address: 1635 Faradal Avenue Suite:
City: Carlsbad State: CA Zip: 92008
Phone Number: 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: Nolan Huelsman
Address: 9449 Balboa Avenue Suite: 270
City: San Diego State: CA Zip: 92123
Phone Number: (619) 299-5550 Fax Number:
Soils Engineer: Ninyo & Moore/ Christina Tretinjak
Address: 5710 Ruffin Road Suite:
City: San Diego State: CA Zip:
Phone Number: 858-576-1000 Fax Number:
Grading Contractor: State License No.:
City Business License No.:
Address: Suite:
City: State: Zip:
Grading Quantities: cut cy fill cy import cy
remedial cy export 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: Suite:
City: State: Zip:
Phone Number: Fax Number:
APPLICANT'S SIGNATURE: DATE:
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