762 M, Modification to the height of , Application07/19/2011 15:22 3103777288
ROLLING HILLS CITY PAGE 04/05
i
. . . ' tiro C, -i_ ,
JUL 2 0 201i
City of Rolling Hiiis
By
EXPORT/IMPORT OF SOIL
UP TO 500 C.Y. OF DIRT MAY BE IMPORTED On EXPORTED FROM A CONSTRUCTION SITE DUE TO SITE
CONDITIONS OR DUE TO UNFORSEEN CIRCUMSTANCES AND ONLY WITH CITY APPROVAL. (RHMC Sections
15.04.130 and 15.04.150)
Property Owner(s) 3 G-' ( i- J o E.0 A
Address(es!l 3 Po t'P t2/a tZ.
Phone No(s). 3 t 6) 3 ? 7 - `7
Reason(s) for export/import soil. Has construction commenced?
C•-t= 5 S S (.4 1R / 1J 1<4 c-r L� ( (1 )/) ,c'tAi ! (G ! �P'� D 1V 7 L 7 c7
61t.v.kt4( Coc)PP1%r.o,3 -- Sv2tie SLI(--j -ram/ Or
ADDRESS 3 Pcw P 9"R r L.
Where soil is proposed to be moved FROM
ADDRESS W ( t-1 «) rtk-VE. e T i)-- C.. A
Where soil is to be moved TO
AMOUNT of soil to be moved (cu.yds.): 1 1:1 0
DEPTH of cut/fill at site (feet) ga ' `1
AREA of cut/fill at site (square feet) 9 4 U O ..
WORKING AT THE JOB SITE: The City Building Inspector/staff must verify the amount of soil to be moved, and after it
has been deposited, the amount of dirt deposited. You must notify City staff should there be deviations or corrections in
the field to modify the approved exportation or importation. The Rolling Hills Municipal Code requires that all grading be
balanced on site and prohibits the export or import of sail to or from any lot in the City or to and from outside the City
unless a`norove d b_City Malr�aaerldesianee under certain conditions.
I understand and agree to abide by these requirements.
Date 7—(9-// Owner/Applioant Date Contractor/Applicant's Agent / License No.
rloop D. !-/rstJEAL /914
Date 7,./ 9- // Engineering Geologist/License No.
EXPORT/IMPORT OF SOIL DURING CONSTRUCTION
2011
O0r1e .. C3 u
Date?-19-I 1 Grading Contractor/License No.
Phone No.
/ � 7/19/2011 15:22 310 77288
ROLLING HIL CITY PAGE 05/05
APPROVED:
DATE
CONDITIONS:
of.
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CITY,,4AN k'� OR DES EE
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Approved ,0 CJi2tAA
PLANNIN� VEPARTMEN'I
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EXPORT/IMPORT OF SOIL DURING CONSTRUCTION
2011
410] TRANSMISSION VERIFICATION REPORT
DATE, TIME
FAX NO./NAME
DURATION
PAGE(S)
RESULT
MODE
07/19/2011 15:22 3103777286
TIMV1E : 07i 20/ 2011 14: 06
NAME : ROLLING HILLS CITY
FAX : 3103777288
TEL : 3103771521
SER.# : EROG5J303281
07/20 14:05
13103255581
00: 00: 38
02
OK
STANDARD
ECM
ROLLING HILLS CITY PAGE 0005
RECE1V .F: D
JUL 2 f) 2011
City of Rolling 1-bi.li;3
By
D_SIV13171 NIP OR3LOF SQ!IL
LIP TO 500 C.Y. OF DIRT MAY SE IMPORTED OR EXPORTED FROM A CONSTRUCTION SITE DUE TO SITE
CONDITIONS OR DU TO UNFORSEEN CIRCUMSTANCES AND ONLY WITH CITY APPROVAL. (RI-INMC Sections
15.04.130 rind 15.04.150)
Property Owners) Act 1u4 7T I I. 0 0 y
Addrest(es)PP'-? i c2,.h 1 t^.
Phone No(s), ( 1 c] ) 74. 7 -2- i 1 2-
Roeson(5) for export/Import soil. Hat construction commenced?
LE-7 5 (.4 g , r t K iri. Or 141 Jai 7 c G d t F :� '1? L,7 4;;. W t ry
ADDRESS 3 ?c)' L `i r L
Where soil is proposed to be moved FROM
ADDRESS , L '-THY '-I r, A
Where soli is to be moved TO
AMOUNT of soil to be moved (cu.yds.) ;_,1 5.. 0
n a-ru of f'H+lolll mt ni+R 1tmn
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