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AF-LA - 45142� - -,v-,:�-. ,� 1� _ 13 . M4r � a: i! �:,"� r + 1 .�; y►�; �- .�4y ' _ - 1• �PPI� CaNi�: � s�� � � /�39�.�.� � /i�d.�- ,��JB k3ciress „ `�.�a� -��`,�-1�,��- /�/�l- SS�i�� 1 Telephone Ntanber ?�� - �jS 8.5 ��►r � l � �l 01 n� 7-�� - �' S� FEE S %S ° � 2. PRO�'Y Q�IAiIIttS) : 5���� � � street Aaaress street Aaaress City, State Zip Code City, State Zip Code � ��- r�3 Offioe Phone eaae Phore Offioe Phone Hame Phone 3. LBGAL D�SQtIP'P�I OF P�ERTY ZV BE ALTF�i�: � r�.o�t / z a�ock L �ract Sz 5r A�2 � O.�/ /�i �, � S Z S s�o-z4�- � � -oo t� ' City State Zip Code r:,���• �• •' n r• i• �:• s• • ��. F� U.vG To � EvEcaP �vt �.p✓�vG s�%� . 5. PtAtP06E OF I.Ai�ID ALTF�iAT��i: � 6. VALUE OF W�tR ZO BE PERFiOtiN�: 8 Z SO 7. sot� x� aoNaaasi�o�t oF �: s'` r wa o,p m�� s, , E 8. PRO�O�SF.D SZARTII�IG I1A�E: �LE�DO� L1ATE: ' c L �S� � 9. ATPACHI�]'t5 tInfonaation Needed to Properly EValuate Applicatior� : � ,ti �, �rie follvwing plans, drawings, calculatians, bonds and/or statenents will be required by the Public Wocks Degart�nent. 8alf section map or sketch of property shawing all adjacent property indicating the exisiting buildinc�s anc]!or structure8. Grading plan showing exisiting and proposed finished contours and evaluations. Drainage plan showing exisiting and proposed drainage structures, stabilization walls, retaining walls, cribbing, daans, or other protective items. _ Calculati�s for and approximate quantities of excavation and/or f ill required. Sic,�ed statenent fram the pcoperty vwrer acoepking responsibilty for the operation and granting penaission for Iand alteration/mining operation. _ Stateaent to be attac�ied to deed advising of potential need for soil tests prior to any o�nstruction on lots where additional fill material has been plaoed. _ Rioe Creek Watershed District Appraval (If Applicable) _ Soil Borings (if require� _ Other 10. STIPUI.ATDQ�iS - RF�AD BEEORE SI(�iII�]G APPLICA�DQ�Is a. A surety bor�d or oeritified check in the amount of S (5� of value of �,rork to be oompleted) must be submitted after approval of application and prior to any work commencing. This bond or check is to ensure satisfactory perf ormance and oomp2ianoe with the below stated stipul.ations. �e surety bond or check shall be kept active until the completion of work and/or expiration of permit and c,�n only be released iyy written notification of the City after a satisfactory final inspection has be� perfornied by Cfty foroes. b. All acoess anc] street frontage of the land alteration site must be oontrolled by a fenoe, a mininKm of fau (4) feet in height. A11 entrances must have qates that are capable of being locked. c. Oril.y rock. sand, gravel, dirt, ac similar natural earth f ill is Penaittec7• No ooncret�e, asphalt, o� clesnolition wastes will be permitted as fill �� a da�alition landfill permit is first obta�ined fran Aroka Co�ty. d. Operations shall be limited to daylight hours and shall not interfere with �e health and safety of surroundinq residents and the pcemises shall be maintained at all times so as not to create a nuisanoe. e. �ny explosives used must be �br�e so in acooFClance with Chapter 212.3, paraqraphs d, e, f, g, of �e Fridley City Code and any other applic�ble standard e.g. Federal, State. Industrial, etc. f. At the en� oi each season's operations and no later than the last day oi Deoe�nber each year, the site is to be left in a neat and orderly condition, wfth maximum slo�es of 2:1 vith no averhang or vertioal banks and with a level bottam. g. On the Friday of ench wock w�eek, or when required by the City. �materiel from this operation that is found to euist on City atreets shall be cleaned to the City's satisfaction by the appliaant. h. Upon oou�letion of land alteration oQerati�s, the land must be left a000rding to the plans and contours submitted with this application and planted with suitable vegetation to prevent erosion. i. Upon vampletion o� land alteration aperations or expiration of this permit, an inspection by the City will be made of the prenises and adjoining streets. Any cYaanage found to have been caused by these aperations will be corrected by the applicant upon notifi�tion �e Ci �- ' �a��� Applicant's Sicg�ature: Date: Property Owner's Sic�r�ature Date: Reoo�miended For Appraval : Drate: AP�RWID BY: Date: 7- Z L- B¢ PF�iNlIT E�IRATIDN DA'PE: y � � u � a• � �• •:�1M��� - ;�I:r. 5�- (�bic yards or less . . . . . . . . . . . . . . . . . . . . . . No i�ee 51 to 100 wbic yards . . . . . . . . . . . . . . . . . . . . . . . 510.00 101 to 1000 c�bic yards . . . . . . . . . . . . . . . . . . . . . . 15.00 1001 to 10,000 wbic yards . . . . . . . . . . . . . . . . . . . . 20.00 10,001 to 100,000 cubic yards - 520.00 for the first 10,000 cubic yarc3s plus 510.00 for each additional 10,000 cubic yards or fraction thereof. 100,001 to 200,000 cubic yarcis - 5110.00 for the first 100,000 cubic yards plus 56.00 for each additional 10,000 cubic yards or fraction thereof . 200,001 cubic yards or more - 5170.00 for the first 200,000 cubic yards plus 53.00 for each additional 10,000 cubic yards or fraction thereof. ,��.�_ �ii yi�;, r• � �,_ ;:n;, 4• s:�. 50 Wbic yards or less . . . . . . . . . . . . . . . . . . . . . . 510.00 51 to 100 cubic yards . . . . . . . . . . . . . . . . . . . . . . . 515.00 101 to 1000 cubic yards - 515.00 for the first 100 a�bic yards plus 57.00 for each additional 100 cubic yards or fraction thereof. 1001 to 10,000 cubic yards - 578.00 for the first 1,000 cubic yarc7s plus 86.00 for each ack3itional 1,000 cubic yarc3s or fraction thereof . 10,001 to 100,000 wbic yarc7s - 5132.00 for the first 10,000 cubic yarcis plus 527.00 for eac� additional 10,000 cubic yards or fraction thereof. 100r001 cubic yards or more - 5375.00 for the first 100,000 cubic yards plus 515.00 for ea� additional 10,000 cubic yards or fraction thereof. 5/L4/3 /Op �'. � a �/S° ° � � , � � 1 � u��'�o�r ��aar�c � � a�iC y�C� �r IE�$B • • • • • • • • • • • • • • • r • • • • • • NO �''E� sl �o loo `�i� �r� R E C E I P T 101 to 1000 cubic y ��� y��� 1001 to 10,000 cubi � �"' //� �t o �rid[e io,00i to ioo,000 c � � plus 510.00 for eac 100�001 to 200�000 �31 University Ave. N.E. yards plus 56.00 f Fndiey, Minnesota 55432 Tel. 571•3450 thereof . 200,001 cubic yarde plus 53.00 for eac� I.AI�ID Ai��IIiAT�ON Qi� 50 C�bic yards or ] 51 to 100 cubic ya� 101 to 1000 cubic ; for eadi addi.tf ona; 1001 to 10,000 cub: 56.00 for eaci� ac3d 10,001 to 100,000 � plus 527.00 for ea 100,001 cubic yard plus 815.00 for ea 51L4/3 /Op c. � � � .._, _ �� 19� N�. 137�1 ALATIAKIT� MOOR[ �VfINf/f IORMf� INC. - N�N��10�1y06