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HomeMy Public PortalAbout10117 LA ROSA DR_Grading__ � aIr.CEd07 APPLICATION FOR GRADING PtRMIT �.. COUNTY OF LOS ANGELES ADDRESS f {_DEPARTMENT OF COUNTY ENGINEER ' BUILDING AND SAFETY DIVISION ocnury � .- .Y--;- JOHN A. LAMBIE. COUNTY ENGINEER "4 CASSATT D. GRIFFIN. SUF-T of BUILDING NEAREST 6' CROSS ST. M Y" FOR APPLICANT TO FILL IN MAP NO, STATE HWV. PRO ED DISTRICT NO. YES❑ NO BY 51[E�. i 'ADDRESS I Q\\ Q D Q QOS A USE TONE SPECIAL 'LOT CONDITIONS NUMii ERS. BLOCK OT _ TRACT � 'NUMBER t ' L^ SETBACK YARD HWY. STREET NAME EXIST. , OWNER cA IDTH MAIL- OD FRONT P.L. t ADDRESSli'l TEL b— CY7r SIDE P.L, CITY _ NO. ' STATsgq E SURETYS BOND e ENGINEER REG. NO. BOND NO. pc SURETY ADDRESS ��W G COMPANY '-- 'SUP_•V'G.GRAD'G. STA E DATEn� - 'ENGINEER. L REG.NO. FILED CASH REC D. DATE ADDRESS DEPOSITS BY FILED GRADINGS TEL. - CONTRACTOR NO. - ADDRESS DESCRIPTION OF WORK ;y CHECK IF SUPERVISED DRAPING - 1 SIGNATURE 'OF-APPLICANT ADDRESS (0143, So A-loO hcAoi NO.:OF CUBIC Y`OS. HANDLED: P.C. 5 00 ^T J W FEE S $ Q�J FEE 3 _ t - WORK TO BE COMPLETED WITHIN - DAYS jlTl-HEREBY .ACKNOWLEDGE THAT 1 HAVE READ THIS - 'g4GR ION AND STATE THAT THE ABOVE IS CORRECT FINAL CONTOUR DATE INSPECTORS SIGNATURE ND,AT REE. COMPLY REGULATING WITH ALL COUNTY ORDINANCES nw FILEo N TATE LAWS REGULATING EXCAVATING AND GRAD- IINAL CE.TIF. �G.�' ... OF ENG'R. RECD. - �NATU RE OF WORK DIS IC !GI EER PERMITTE CO PLETED f SURETY Bono `7fl E55 Q�� �� RELEAEEO CLYDE N. DIRLAM. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK,VALIDRTION cK. M.O. CASH PERMIT VALIDATION CK. M.G. CASH 2 0 4 7 JL'iV 15 1 3 D 1 0,00 v of L 3 9 3 AUG 3 4 D 3 1 .00-