LAND ALT 08.832.
2.
APPLICANTS
Name
Address
7/^ ® %
Telephone Number
PROPERTY OWM(S) :
M Y •
si/- 6 94i s71 -a3 o 7
Office Phone Bane Phone
RDCEIPT #
FEE $
,'=- / v L D
Street Address
E2��
City, State Zip Code
57/- 61.4- S' 7/, - a 7
Office Phone Home Phone
3. LBGAi, DESCRIPTION OF PROPERTY M BE ALTERED:
Lot Block Tract
City State Zip Code
5.
6.
DAZES
9. ATLACHMEMS (Information Needed to Properly Evaluate Application):
Rte following plans, drawings, calculations, bonds and/or statements will
be required by the Public Works Department.
_ Half section map or sketch of property showing all adjacent property
indicating the exisiting buildings and/or structures.
_ Grading plan showing exisiting and proposed finished contours and
evaluations.
_ Drainage plant showing exisiting and proposed drainage structures,
stabilization walls, retaining walls, cribbing, dams, or other protective
items.
_ Calculations for and approximate quantities of excavation and/or f ill
required.
_. Signed statement from the property owner accepting responsibilty for
the operation and granting permission for land alteration/mining
operation.
_ Statement to be attached to deed advising of potential need for soil
tests 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. STIPULATIONS - READ BEFORE SIGNING APPLICATION:
a. A surety bond or ceritified check in the amount of $
(5% of value of work to be oampleted) 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. 7he surety bond
or check shall be kept active until the completion of work
and/or expiration of permit and can only be released 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 land alteration site must
be controlled by a fence, a minimum of four (4) feet in height.
All entrances must have gates that are capable of being locked.
c. Only rock, sand, gravel, dirt, or similar natural earth f ill is
permitted. No concrete, asphalt, or demolition wastes will be
permitted as fill unlgss a demolition 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 premises shall be maintained at all times so as not to
create a nuisance.
e. Any explosives used must be done so in accordance with Chapter
212.3, paragraphs d, e, f, g, of the Fridley City Code and any
other applicable standard e.g. Federal, State, Industrial, etc.
f. At the end of each season's operations and no later than the
last day of December 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 bottom.
g. On 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 ompletion of land alteration operations, the land 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 adjoining streets. Any damage found to have been
caused by these operations will be corrected by the applicant
upon notification by the City.
Applicant's Sign
Property Owner's
Recommended For
APPFDM BY:
Date:
Date: `d-
7/'
Date:
Date:
LAND ALTERATION PLA*-CHBCKDG FEE'S
50 Cubic yards or less ... No Fee
51 to 100 cubic yards....... 0 0 0 0 0 0 0 0 0 ..... 0 $10.00
101 to 1000 cubic yards. . . . . . . . . . . 0 0 0 . 0 . . . . . . 15.00
1001 to 10,000 cubic yards . .. .. . . 20.00
10,001 to 100,000 cubic yards - $20.00 for the first 10,000 cubic yards
plus $10.00 for each additional 10,000 cubic yards or fraction thereof.
100,001 to 200,000 cubic yards - $110.00 for the first 100,000 cubic
yard plus $6.00 for each additional 10,000 cubic yards or fraction
thereof.
200,001 cubic yards or more - $170.00 for the first 200,000 cubic yards
plus $3.00 for each additional 10,000 cubic yard or fraction thereof.
LAND ALTERATION GPADIM PERMIT FEES
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 yard 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 yards plus
$6.00 for each additional 1,000 cubic yard or fraction thereof.
10,001 to 100,000 cubic yards - $132.00 for the first 10,000 cubic yards
plus $27.00 for each additional 10,000 cubic yards or fraction thereof.
100,001 cubic yards or more - $375.00 for the first 100,000 cubic yards
plus $15.00 for each additional 10,000 cubic yards or fraction thereof.
5/1/4/3
11
1p C::, S/L 983
DAY -TIMER Dotgn•A•Form Re Order No. 844080 ® DAV-TIMERS, Allentown, Pe. 18001 Printed in U.S.A.'
M
11
1p C::, S/L 983
DAY -TIMER Dotgn•A•Form Re Order No. 844080 ® DAV-TIMERS, Allentown, Pe. 18001 Printed in U.S.A.'