HomeMy WebLinkAboutCazadero Pl 21503 (CODE - Grow House) PR24-0256_POTATO CONSTRUCTION INC.pdfAk 4?k,
- City of Diamond Bar
DIAMOND BAR
C,L,=oRRIA Construction & Demolition (C&D) Debris Plan
Required for all covered projects, 1,000 sq. ft or more. The deposit shall be returned, to the applicant, without
interest, in total or proportion upon submittal ofproof that no less than 75% of the C&D was diverted.
Use of unauthorized waste haulers may also result in forfeit of the deposits.
Receipts and weight tickets can be submitted to: ereendb(a)d1amondbarca.s=ov
Complete before obtaining it building, combination or demolition permit.
Submit this form and your deposit to the Building and Safety Division Iocated at. 21810 Copley Dr. Diamond Bar, CA. 91765
Applicant Contact Information:
Name L� zhwl Title r Company
Address u { City '; c" r c • n State a Zip
Phone Email
Project Information: ■
Permit No. PP, 24 - OZCp ❑ Valley Vista WM If Haul
Project Address 44503 Caz�rc�XrS
Project Type: ❑ New Construction ❑ AdditionlAlteration
Building Type: 0 Commercial kResidential
Estimated Square Feet
Estimated Start Date 1 1
Estimated Completion Date 1 1
Zip
Demolition
TO BE PILLED OUT BY CITY STAFF
"C&D Deposit" Paid $ v7 04
Staff Initials ftV` Date Paid
Fill out the table with estimated quantities in tons for each material that will be generated by your project. Note: A + B = C
Material Type
A E B
Estimated Salvage,: Estimated
Reuse or Recycle E Disposal (Trash)
C
Estimated Total
Debris Quantity
Applicant Self
Haul (check)
Certified Recycling
Facility or
Disposal Destination
Asphalt & Concrete
0.00
Brick 1 Masonry 1 Tile
0.00
Cabinets, Doors, Fixtures,
Windows (circle all that apply)
0 00
❑
Cardboard
0.00
Carpet, Padding 1 Foam
0,00
Ceiling Tile (acoustic)
0.00
Dirt
0.00
Drywall
0,00 -
Landscape Debris
0,00Li
Mixed C&D Debris
0.00
Mixed Inerts
0.00
Roofing Materials
0.00
Scrap Metal
0,00
Stucco
0,00
Unpainted Wood & Pallets
0.00 (..-
Garbage 1 Trash
0,00 .
Other:
0.00 i
TOTAL
0.00 :0.00 10.00
To estimate Recycling Rate: (Total A/Total C) x 100 = Re g % 0.00%
Applicant Name: ^:- Jl t��� X Signature: 1 1 Gate:
For information on construction and demolition waste management plans contact the City of Diamond Bar
Environmental Services at 909.839.7015 or via email to xreendbAdiamondbarca.gov
- 1 - 09/28/17