HomeMy WebLinkAboutRP 15-16; 4 PLUS 1 LUXURY LIVING; Engineering ApplicationAPPLICATION
GRADING PERMIT
E-24
Land Development Engineering
1635 Faraday Avenue
760-602-2750
www .carlsbadca.gov
~ PERMIT NUMBER:
Project Name: \ ::!.::I ( dJ I N C)
Project Location: &, ,<;;'r) ,Q 1'\f)(S:1...\1.,_\ ~./-i-'{Z.(.:;:'(-:S~O Drawing Number: --=='-=--'_._J.--'--------1
Assessor Parcel Number(s): :l--u ?,;,_... -;s \_ D~~-~c --=--'--~"-=-=---=--=c..---'--,-------------=----------1
Project Description: ""'+<:..To~--( l'V\\t..bf) u<(G-I Cf)/(\,fla2.Ci1-4L---t° ~0-er-i71A1..-
Owner: ,--S. T ~•l\~ (\¼,\;Fl \ c,<; (,...1..-,!..
Address: \O\C} f~~--S'f Suite: _.,_"L. _____ ___.
City: ~ _ )',;,\,....1.--;+-State: C-A Zip: _e-_,_1'=2-:...:u:__:• .5==-"..,_--------t
Phone Number: ~ 5~ ) S-41 'o -2--LJU(.:. 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: ~ { <3.. ~
Address: ·) £~ LD1'--'1-'-~"-'""'-'C.-J~• i_;~··~N~I ~_,_,__~~-4--'-----------------Suite: -C-1 fr_·_o ____ --1
City: _SA;A DtS-Li.1 State: CA-Zip: _ _,c_,--:Z._1_G;:c._:_,,,6.,,"'-·--~
Phone Number: tp1~ J ;}.:)(/J -55Jp~ Fax Number:
Soils Engineer: ~-·cK 5
Address: Go °fJ1·~-,..;.. \I £.(t:; Suite: --------I
City: kh'=---6:-~t \)~ State: ......---,-\; Zip: _'1,__2.D'---'-'------1
Phone Number: a,(~ ) .A-1::3-&:x;;O Fax Number:
Grading Contractor: W /i i' _L () C--1, ~ • /),.tl-~ , I"' c.. State License No. /-=-t?....,,O:.,.,:D~Oc.___,_l----1--=-..'--------t
c:1/ City Business License No : PJL05' ').~~.).'It)
Address: f V VS~ ;)-. 's ;) 2.. Suite
City: C. (Vl.ed.:.. State: (! A Zip: ........ C/l-'IJ-t'-tJ~if-J..-------1
Grading Quantities: cut i/-(p12 cy fill / {J cy import ______ cy
remedial r cy export ~ ~ cy
Qualified contact person trained in NPDES requirements
Phone Number: v
Basis of Permit Fees:
Verified By:
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. <;"; .C-,·/( --1---£l ,./1 <"
ApplicantName· /S~le rr,·1..,y/ 1/':::>/r•:::> ~~ ,LLC--
Address: / 0 I 17 a.,.-V)... Suite: • ~
City: l.. J 12 / 4 State: A Zip ........ ------1
Phone Number: ~ §~ _ 5l, o=='-:J..ooO Fax Number: &5~ ---"--f-'--~,..:--.=:.......<.__,,__---1
APPLICANT'S SIGNATURE: DATE:
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