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grading permit applisa oig <br /> % (To be accompanied by two copies of grading plan) PERMIT NO. <br /> Q O 1 11 II <br /> Location S i S !r y el Al £ N NW N Aud N i N8 Jj <br /> u -� S E y f/W 4 5-7 T 4N f-7o a <br /> 1 <br /> Job address C7£A#+�,ATv CAwf-.., Nd / dSmilf R4 UY s <br /> Legal description (or attach) 5f S A 6a0 f_ JE 17 0i,/ V Oki/'&n 15?,rl <br /> Subdivision Nam' Block(s) N A <br /> Lot(s) A Mining Claim /✓ <br /> Proposed land use or purpose SA'N S7-­YNL op%:A/ a✓wY <br /> Owner /A I?. /J/£/ SW An u l; Rfw 40J Pvlc i�Ta•+£ <br /> Address 10r• 2 ROk 97-A -2[A 4,d a", 805'/3 Phone No. 53Z -,Z 73 <br /> Grading Plan (two copies attached) <br /> Prepared by P.E. license No. <br /> Address <br /> Phone No. <br /> Topographical base prepared by <br /> State license type and No. Phone No. <br /> Address <br /> Sea! testing fi -rn- <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) I rd2: /2 7ovs INcl,,d,.9 <br /> Cut 3D0-�'00 7-# eCAYCAr(145A61fa (70oT,)`,Y7'-7711)mported fill ACE_ <br /> On-site fill %0-3so 7_AY le,e I'_A Exported fill /o0 — 30o T.P. y Rip /F p <br /> Estimated valuation of grading $ - 7S iw 1p,,ePAp 3S� <br /> c <br /> Indicate site of disposal of exported fill 9D�jwAs7£ otil itS (�Qk� �£ Ik,M. � <br /> Quantities calculated by µ=- P.E. license No. /y,/A <br /> ACKNOWLEDGEMENT : I hereby acknowledge that I have read this applicaton and state that the <br /> information 1 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, itsofficers, <br /> agents, and employees to enter upon the land for the purpose of such inspections, investigations, <br /> or corrective action as the Chief Building Inspector of Boulder County deems necessary. <br /> Signature <br /> .0 <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 />