HomeMy WebLinkAboutPD 2021-0013; 3367 APPIAN RD; Engineering Application~ City of
Carlsbad
APPLICATION
GRADING PERMIT
E-24
Development Services
Land Development Engineering
1635 Faraday Avenue
760--602-2750
www.carlsbadca.gov
I PERMIT NUMBER·
Project Name: Slope Failure Repair Project Number: GR2021-0007
Project Location: 3367 Appian Road Drawing Number: 530-lA
Assessor Parcel Number(s): 167-370-02
Project Description: Slope Failure Repair
Owner: Bruce Blandy
Address: 3367 Appian Road Suite:
City: Carlsbad State: CA Zip: 92010
Phone Number: 760-224-6262 Fax Number: N/A
I certify that I am the legal ~er °j{f his property and I authorize the grading associated with this permit.
OWNER SIGNATURE· • , , LL~~ .. / DATE: o 7 f.e.s 202.-J
Civil Engineer: BHA, Inc. I I
Address: 5115 Avenida Encinas Suite: L.
City: Carlsbad State: CA Zip: 92008
Phone Number: 760-931-8700 Fax Number: 760-931-7780
Soils Engineer: Advanced Geotechnical Solutions Inc.
Address: 485 Corporate Drive Suite: B
City: Escondido State: CA Zip: 92029
Phone Number: 619-867-0487 Fax Number: N/A
Grading Contractor: P. B. A. Ltd. South State License No.: 1081694
City Business License No.: BLRE 010677
Address: 4135 Park Drive Suite:
City: Carlsbad State: CA Zip: 92008
Grading Quantities: cut 0 cy fill 3 cy import 3 cy
remedial 8 cy export 0 cy
Qualified contact person trained in NPDES requirements: P. B. A. Ltd. South -Kevin Dohertv
Phone Number: 760-801-5238
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: Bruce Blandy
Address: 3367 A~~ian Road Suite:
City: Carlsbad I II State: CA Zip: 92010
Phone Number: 760-224-6262_,/ /4. , Fax Number: N/A
APPLICANT'S SIGNATURE: c 01'0,)/.ff,,,,,~l,, DATE: () ~ =ki8 Z&:>22-
I y
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