HomeMy WebLinkAboutEagle Nest Dr 347 (Roof) PR24-0440_PREMIUM ROOFING SYSTEMS.pdfCI l T Of .....
DIAMOND BAR
City of Diamond Bar
Construction & Demolition (C&D) Debris Plan CAllfOIIIA
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 of proof 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: greendb@diamondbarca.gov
Deposit (per project): $50.00 for each estimated ton, but no less than $250 and not to exceed $5,000
Complete before obtaining a building, combination or demolition permit.
Submit this form and your deposit to the Building and Safety Division located at: 21810 Copley Dr. Diamond Bar, CA. 91765
Applicant Contact Information:
Name Ao.r-,o..-A \J o..z...ttye., -z.., Title GoV'-~'" ~c,t"' Company ?~W'\\W>A -(2._~I\•
Address ,ZO$'"{ (AV\~~A.~~\ Av-f!.. City Gs~"' State~Zip "ll'&Z,-'r .,
Phone G\. °'--S l, l, -\ 1"~ Email.,._..~.~~ A vv-o.,\.c..--
Project Information: -----::~.
Permit No. D Valley Vista D WM I ,<..I Self Haul
Project Address 'E°'-.~~ 1'.Je~ Qr. a~°'"~ Zip q,~6~
WDem;iiJon • ~,o~ Project Type: D New Construction a· Addition/Alteration
Building Type: D Commercial Residential
Estimated Square Feet '2-, 'lO D TO BE FIIJ.ED OUT BY CITY STAFF
"C&D Deposit" Paid $ L-{ ~°'--z~ Estimated Start Date I I cs I ,z_t..-t_ Staff Initials Date Paid Estimated Completion Date I
Fill out the table with estimated quantities in tons for each material that will be generated by your project. Note: A+ B = C
. '
A • B . C Certified Recycling . Applicant Self . Material Type . Estimated Salvage,: Estimated Estimated Total Haul (check) Facility or
Reuse or Recycle Disposal (frash) Debris Quantity Disposal Destination
Asphalt & Concrete 0.00
Brick / Masonry / Tile • 0.00 . Cabinets, Doors, Fixtures, 0.00 Windows (cin;le all that apply)
Cardboard . 0.00 -
Carpet, Padding / Foam I 0.00
Ceiling Tile (acoustic) 0.00
Dirt 0.00 -
;
Drywall . 0.00
Landscape Debris 0.00 -.
Mixed C&D Debris '%, .
~Ot\.S 0.00 ~· fv\Oo.\\ft"\ ~~\--\~
Mixed Inerts C 0.00
Roofing Materials . 0.00
Scrap Metal 0.00
Stucco I 0.00
Unpainted Wood & Pallets : 0.00 -. •
Garbage I Trash 0.00 -
Other: . 0.00 111111111111111 . .
TOTAL o.ee-! 0.00 0.00
To estimate Recycling Rate: (Total Affotal C) x 1001= R~cling % 0.00%
!Applicant Name: Mc-,o...--\J <>-.~v(.} Signature: _ /i Date: '-1 /,ca /zy
._/ .......... '----I
-
For infomuwon on construction and j:lemolition waste management plans contact the City of Diamond Bar . Environmental Services at 909.839.7015 or via email to greendb@diamondbarca.gov
-1 -09/28/17
PR24-0440
250.00
AV