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nX � I toll F 0. <br /> 9fading p6mit epnlicati®nO <br /> (To be accompanied by two copies of grading plan) PERMIT NO. <br /> VNetl G• 5 ��4 ue <br /> Location /61 tnIES Ne4 o-' 7- <br /> Job address 54'Mf- <br /> Legal description (or attach) 5 £ 5 7 r3N oe 7ft4� <br /> Subdivision Block(s) /A ,5R 7. <br /> Lot(s) 'VIA Mining Claim N <br /> Proposed land use or purpose '34"j 570"[ bG+ rn;AAvq PA fey <br /> Owner Stmu £ ({ �crLNser flll£n $£Iry AaEA,•Tow &45f C*-7rAe SPfASu� <br /> Address S'YO 55;<A rArKwAy Zb L, 50303 Phone No. _E3Q- 373 <br /> Grading Plan (two copies attached) <br /> Prepared by P.E. license No. <br /> Address <br /> Phone No. <br /> T000qraphical base prepared by <br /> State license type and No. Phone No. <br /> Address <br /> Soil testing firm <br /> Soil engineer* P.E. license No. <br /> Address <br /> Phone No. <br /> Engineering geologist, if any* <br /> Address Phone No. <br /> Earthwork quantities (cubic yards) 60 % wA57-L r f /2AO <br /> Cut 300 T,N u,sA6lf_ - we +r&j ) YEAf- Imported fill Now.£ <br /> On-site fill All Lp PAa 900 Te. Exported fill £- <br /> Estimated valuation of grading $ 35.'.� To* 57-c,L <br /> Indicate site of disposal of exported fill /4)0-K <br /> Quantities calculated by M0 . S4rA WC P.E. license No. /✓ <br /> ACKNOWLEDGEMENT : I hereby acknowledge that I have read this applicaton and state that the <br /> information I have provided is correct and I agree to comply with all relevant codes and regulations <br /> of Boulder County which regulate grading. Consent is hereby given to Boulder County, its officers, <br /> agents, and employees to enter upon the land for the purpose of such inspections, investigations, <br /> or corrective action 'aas the Chief Building Inspector of Boulder County deems necessary. <br /> Signature <br /> / A Z <br /> *Per Section 7006(e) and 7006(f) , soil and geology reports will be required unless specifically <br /> exempted by the Chief Building Inspector. <br /> VALIDATION : This application, when properly validated and approved by the Chief Building <br /> Inspector, is a permit to do the work described for a period of from date of issuance. <br />