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LAND ALT 5266Receipt # 6� 6(, Fee: $ CITY OF FRIDLEY LAND ALTERATION PERMIT Effective November 3, 2000 APPLICANT / �® ��� Tel. # ,2 - 9Pf C2 / Address / WO �Up 00/IVA VP PROPERTY OWNERS NAME %/A-E Tel. # Address 10, NAME Address Tel. # LEGAL DESCRIPTION OF PROPERTY Lot Block Addition Address: AIM 64% DAXA4� /CIO Value of Work: $ DESCRIPTION OF LAND ALTERATION Starting Date: Completion Date: Source and Composition of Fill:6AeV,4E 64,Q AVdZ4 A1UW PURPOSE OF LAND ALTERATION ATTACHMENTS TO APPLICATION The following plans, drawings, calculations, bonds and/or statements may be required by the Public Works Department: ion map or sketch of property showing all adjacent property indicating the existing buildings and/or plan showing existing and proposed finished contours and evaluations. age plan showing existing and proposed drainage structures, stabilization walls, retaining walls, cribbing, or other protective items. Calculations for and approximate quantities of excavation and/or fill required. Signed statement from the property owner accepting responsibility for the operation and granting permission for land alteration/mining operation. Statement to be attached to deed advising ofpotential need for soil tests prior to any construction on lots where additional fill material has been placed. .Rice Creek Watershed District Approval. Soil Borings Other STIPULATIONS READ BEFORE SIGNING APPLICATION 1. A surety bond or certified 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 released by written notification of the City after a satisfactory final inspection has been performed by the City. 2. 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. 3. Only rock, sand, gravel, dirt, or similar natural earth fill is permitted. No concrete, asphalt, or demolition wastes will be permitted as fill unless a demolition landfill permit is first obtained from Anoka County. 4. Operations shall be limited to daylight hours and shall not interfere with the health and safety of surrounding he premises shall be maintained at all times so as not to create a nuisance. Stipulations Continued 5. Any explosives used must be done so in accordance with Chapter 212, subsections 212.07.5A, .5B, .5C, .5D, and .5F. of the Fridley City Code and any other applicable standards, e.g. Federal, State, Industrial, etc. 6. 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. 7. 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. 8. Upon completion 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. 9. Upon completion of land alteration operations or expiration of this permit, an inspection will be made by the City 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. � Date: 91A�IAppy Signature Property Owner's Signature Property Owner's Signature Date: Date: FOR CITY USE ONLY Recommended for Approval B : Date: Approved By: Date: % 8 �� PERMIT EXPIRATION DATE: 40 0 LAND ALTERATION PLAN-CHECIIONNG FEES 50 Cubic Yards or Less ....................................................... No Fee 51 to 100 Cubic Yards ....................................................... $ 23.50 101 to 1,000 Cubic Yards ..................................................... $ 35.00 1,001 to 10,000 Cubic Yards .................................................. $ 49.25 10,001 to 100,000 Cubic Yards ................................................. $ 49.25 for the first 10,000 cubic yards plus $24.50 for each additional 10,000 Cubic Yards or fraction thereof. 100,001 to 200,000 Cubic Yards ............................................... $269.75 for the first 100,000 cubic yards plus $13.25 for each additional 10,000 cubic yards or fraction thereof. 200,001 Cubic Yards or More .................................................. $402.25 for the first 200,000 cubic yards plus $7.25 for each additional 10,000 cubic yards or fraction thereof. LAND ALTERATION GRADING PERMIT FEES 50 Cubic Yards or Less ....................................................... $ 40.00 51 to 100 Cubic Yards ........................................................ $ 47.50 101 to 1,000 Cubic Yards ..................................................... $ 47.50 for the first 100 cubic yards plus $10.50 for each additional 100 cubic yards or fraction thereof. 1,001 to 10,000 Cubic Yards ................................................... $167.00 for the first 1,000 cubic yards plus $9.00 for each additional 1,000 cubic yards or fraction thereof. 10,001 to 100,000 Cubic Yards ................................................. $273.00 for the first 10,000 cubic yards plus $40.50 for each additional 10,000 Cubic Yards or fraction thereof. 100,001 Cubic Yards or more .................................................. $662.50 for the first 100,000 cubic yards plus $22.50 for each additional 10,000 cubic yards or fraction thereof. GERALD T. COYNE 310 BRUNSWICK AVE. S. GOLDEN VALLEY, MINN. J EERY RAT11 LOT SURVEYS COMPANY LAND SURVEYORS REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED BY ORDINANCE OF CITY OF MINNEAPOIAS 5747 West Broadway 538-9922 Minneapolis, Minnesota 55428 #IIP rgarB ` e ni�tr Ip' „? ✓' /.areo A M RAYMOND A. PRASCH 6917 IDAHO AVE. N. r BROOKLYN PARK, MINN. INVOICE NO. 5h51 F. B. NO. 67-3 SCALE I" 30' O — DENOTES IRON -1. DP.r,O-es 'Mood Hut. Set For Excavation Only i` j N� Jr 1 I// e G t 1,01, 18, Block I, IW433RF,'Jr1K NORTii 2ND ADDI'PION Revised January 18, 1978 We hereby certify that this is a true and correct representation of a surveyy of the boundaries of the above described land -and the location of all build- ings and visible encroachments, if any, from or on said land. Surveyed by us this 25 day of F eb rua ry� 19 77 1=./�/r/ t i 1 � Signed SUR YS COMPAW I V