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AF-LA - 46673e N � � � LYiIJ.Yai � Ar.mF:w�Tr�i P�IIT l. APPLICANI': . /'�� .A �c�'1 � � � RF7CEIPT # �" �`.� NaQne � � !'/ .�� DATE 7��8� Address s�/-/��s�� Telephone NLUnber 2. PROPEi�1.'Y OWi�R(S) : ,�(� Il�� N�,O� N�ne IZ� �. `a �l.LI..�WO Street Address' li�2c. � i�1�J Ss�'�'� City, State Zip Code �i /��e�� Office PY�one Eame Ph�ne � o_o FEE $ � N�ne Street Addr�s City, State Zip Code Office Phone Home Pl�ne 3. L�G�L DESCRIPTI�11 OF PROPF�'Y ZO BE ALTER�: � �1 I �00 ��. Block � Tract A�1 � �� Zj 4. City State Zip Code OF LAI�ID ALTERATION OPERATIOri �LL �� 5. PtIRPOSE OF T�AND ALTERATI�i; '��w� � Aoa V� 6. VAI�JE OF WORR TO BE PF.RF'ORMED: $ � 7 . 90URCE AI�ID (70N�OSITION OF FILL: d��'� q � �°D�'ebe � �� ' a � ° �� "�`� %.�� 3�C i� ��.; r��'�� °a �� , '� ��g�°�� a3 � � ��vM� 8. PROPOSID ST.A�NG �TE: � � � � �� ODN�L�,TION DATE: � � �� 9. (Information Needed to Properly Evaluate Application): The follawing plans, drawings, calculations, bonds and/or statc�nents will be required by the Public Works Department. ❑ Half section map or sketch of property showing all adjacent property indicating the exisiting buildi.ngs and/or structures. C] Grading plan showing exisiting and proposed finished contours and evaluations. [] Drainage plan showing exisiting and proposed drainage structures, stabilization walls, retainirig walls, cri.bbing, dams, or other protective items. � ❑ Calculations for and approximate quantities of excavation and/or f ill required. . [� Signed statenent from the property owner accepting responsibilty for the operation and granting permission for land alteration/mining operation. ❑ Statenent to be attachecl to deed advisi.ng of potential neea for soil t�ts prior to any construction on lots where additional fill material has been placed. ❑ Rice Creek Watershed District Approval (If Applicable) ❑ Soil Borings {if required) ❑ Other 10. SPIPiJIATIONS — READ BEFORE SIGNING APPLICATION: a. A surety bor� or ceritified check in the amount of $ (5$ of value of work to be completed) must be submitted after approval of application and prior to any work commencing. This bond or check is to ensure satisfactory performance and compliance with the below stated stipulations. The surety bond or check shall be kept active until the completion of work and/or expiration of permit and"can only be releasecl by written notification of the City after a satisfactory final inspection has been performed by City forces. b. All access and street frontage of the lanc7 alteration site must be controlled by a fence, a minimum of four (4) feet in height. All entrances must have gates tYflat are capable of being locked. c. Only rock, sand, gravel, dirt, or similar natural earth f ill is permitted. No concrete, asphalt, or denolition wastes will be permitted as fill 1�p1�� a cleqnolition landfill permit is first obtained from Anoka County. d. Operations shall be limited to daylight hours and shall not interfere with the health and safety of surrounding residents and the prenises shall be maintained at all times so as not to create a nuisance. e � � • �i� � �+• • �' M:iJ�� t�. 50 C�bic yards or less . . . . . . . . . . . . . . . . . . . . . . No Fee 51 to 100 cubic yarc7s . . . . . . . . . . . . . . . . . . . . . . . $10.00 , 101 to 1000 cubic yards . . . . . . . . . . . . . . . . . . . . . . 15.00 1001 to 10,000 cubic yarc7s . . . . . . . . . . . . . . . . . . . . 20.00 10,001 to 100,000 cubic yards -$20.00 for the first 10,000 cubic yarcls plus $10.00 for each ac7ditional 10,000 cubic yarcls or fraction thereof. 100,001 to 200,000 cubic yards -$110.00 for the first 100,000 cubic yards plus $6.00 for each additional 10,000 cubic yarc7s or fraction thereof. � 200,001 cubic yards or more -$170.00 for the first 200,000 cubic yarcls plus $3.00 for each adc7itional 10,000 cubic yarcls or fraction thereof. IAI�ID ALTERATION GRADII� PERMIT FEFS 50 Cubic yards or less . . . . . . . . . . . . . . . . . . . . . . $10.00 51 to 100 cubic yards . . . . . . . . . . . . . . . . . . . . . . . $15.00 � 101 to 1000 cubic yards -$15.00 for the first 100 cubic yards plus $7.00 for each additional 100 cubic yards or fraction thereof. 1001 to 10,000 cubic yards -$78.00 for the first 1,000 cubic yarcls plus $6.00 for each adr]itional 1,000 cubic yards or fraction thereof. 10,001 to 100,000 cubic yards -$132.00 for the first 10,000 cubic yarcls plus $27.00 for each additional 10,000 cubic yards or fraction thereof. 100,001 cubic yarcls or more -$375.00 for the first 100,000 cubic yards plus $15.00 for each additional 10,000 cubic yarc� or fraction thereof. �S'O �'1: = o�� °� � ��, � �� s e. Any explosives used must be clone so in accordance with Chapter 212.3, paragraphs d, e, f, g, of the Fridley City Code and any other applicable standard e.g. Fecleral, State, Industrial, etc. f. At the end of each season's operations and no later than the last day of Decenber each year, the site is to be left in a neat and orderly condition, with maximum slopes of 2:1 with no overhang or vertical banks and with a level bottam. g. � the Friday of each work week, or when required by the City, material from this operation that is found to exist on City streets shall be cleaned to the City's satisfaction by the applicant. h. Upon completion of larid alteration operations, the lanol must be left according to the plans and contours submitted with this application and planted with suitable vegetation to prevent erosion. i. Upon completion of land alteration operations or expiration of this permit, an inspection by the City will be made of the premises and adjoi.ning streets. Any damage founc7 to have been causec] by these operations will be corrected by the applicant upon notification by the City. Applicant's Signa Property Owner's °� ' �.,,�� ' �'� . ---�-=�.�"---� Reco�nended For Approval By: Date: APPROVID BY : � :��1�' �� Date : � �� PERMIT F�IRATION DATEs _.�