15-07 Land Alt 6311 Shawn Lashovsky Quincy St NeCITY OF FRIDLEY
LAND ALTERATION PERJ\I[IT
Tel.#612-(,(,2 -76g:r
PROPERTY OWNERS .....1.\ \.....~,
NAME $\"'"..'"vsl"oYSty
Addre"t,3t1 0 ....,A<-l(sf ,AIf.7NAME _Tel.#_
AddreS'_
LEGAL DESCRIPTION OF PROPERTY
Lot _
A(klre~s·
Block CW.')fle.-Addition ''_
DESCRIPTION OrLAND ALTERATION
V.IlIe of Work·$ /~OO.{)O Starting Date:_7'-11",1:.L1_--:-_CompletionDate -,f!'4-!"'''''-._
Source and Composition ofFill:r;,r~J+L"l::.e...;)",,£i
PURPOSE OF LAND ALTER<\.TIO.
ATTACHMENTS TO APPLICATION
The following plans,drawings,calculations,bonds andlor statements may be required by the Public \Vorks Departmem:
Mall':eslienmal3 af sketch ofpropeI1y showing all adjacent property indicating theexisting buildings and/Or structures.
l J Gradlllg plan showing ~xistUlg and proposed fuushed contours and e'valu3tJ.ons.
[J Drall1age plan showing existing and proposed drai.nage Slmctures,stabIlization walls,retallung walls,cribbing,dams,or
other protective items.
[ ]Signed statement from the property owner accepting re5ponsibility for the operation and granting permission for land
alteration/mining operation
[1 Statement tobe attached to deedad\"lslIlg ofpOlemial need for soil tests priortoany COI1.5U11Ction on lots where additional
fill mat~rial has been placed.
[]RIce Creek Watershed Dis~ict Appro"/a'.
[ ]Soil Borings
[XJ 0th.:r Srlow stoc:.-cpiles and silt fencing or other erosion control device
downstre~n of stokpile area.
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STIPULATIO S
READ BEFORE SIGN!G APPLICAnON
1 A st.-ell'bond or cenifled check in the amount of S (Waived)(3'1i{',j(",.W.JtY,fu"HH'oY~l'ef~)must be
submitted after approval ofapplication and prior to any work commencing.Tllis bond orcheck is toenSLU"e satisfactory
perfonnance and compliance with the below stated stipulations.Thesurety bond orcheck shail be kept active until the
completion of work and/or expiration of pennit and can only be released by written notification of the City after a
::;atisfactory final inspection 1185 be-en performed by the City.
All access and street frontage of tlle bnd alteration site must be controlled by a fence,a minimum oftoW'~--1)feet 111
height.All entrances mus!.have g.ates that are capable of being k1Cked.
3 Only rock,sand,gravel,dilt,or sunilar natural earth fill is penllitted.Noconcrete,asphalt,ordemolitionwastes will be
pennitted as fill tUlless a demolition landfill pennit is first obtained from Anoka COWlty.
upaationsshall be limited to daylight hours and slmll not interfere with the health and safety ofsun'olUlding residents
and th~pr~rnisesshall be maintained at all times so as not to create a Iluisance.
5.Any e:-.plosives usedmust bedoneso in accordance with Chapter ~l~,subsections ::::1 ~.Ui .5A,.5B,.5C,.5D,and .SF.of
the Fridley City Code and any other applicable standards.e,g.,Federal,State.IndlJ.')trial,etc.
6.At theend ofeachseason's operations and no laterthan the last day ofDec~iilwreach year,the site is to be left in a neat
and orderly condition,with maxirnwll slopes of 2:I .....ith no overhang or venical banks and with a level boltom.
7.On the Friday ofeach work week,or when required by the City,material from this operation that is [mUlel to exist on
City streds shall be cleaned to the City's satisfaction by the applicant.
8.Upon completion oflandalteration operations,the lanclmustbe left according to the plans andcontours submitted\~...ith
this applicatIon <lnd planted with suitable ve-getation to prevent erosion.
9.Upon compleuonofland alterationoperation.s orexpirationofthis pennit,an inspection will be made by the City ofthe
premises and adjollung streets.Any damage found to have been caused by these operation;;will be con'ected by the
applicant upon nctiflcation by the City.
Date 7!Z.,Ir-S-,
Property Owner's Signature
Date·_
!'OR CITY IJSF,ONLY
Recommended for ApI'ov
Approved By:-'"
JPERMITEXPIRAllON DATE:~
50 Cubic Yards or Less..
51 to 1()()CubJC Yards
101 to 1.000 Cubic Yard,
1,001 to 10,000 Cubic Yards
10.00l to 100,000 Cubic Yards.
1O~.001 to ]00,000 Cubic Yare:..
~OO,()O:Cubic Yards or :More
L.ND ALTERATlON PLAN·CHECKING FEES
.No Fee
..$"3.50
....$3500
.....$49."5
$49"5
for the ftrst 10,000 cubic yards plus$2450 for each
additional 10.000 Cubic Yards or fraction thereof.
..$269.75
for t.he first 100,000 cubic yards plus $13.25 for
eac~additional 10,000 cubic yards or fraction
thereof
...$40""5
fort.he first 200,000cubic yards plus $7.25 for each
additional 10,000 cubic yards or fraction thereof
50 CubIC Yards or Les:"..
:'1 to 100 Cnbic Yards .
101 to 1.00n Cubic Yards.
1.IX'll to 1O.f(lO Cubic Yarris.
1:l.()(n to 100.000 Cubic Yards.
lO(),Onl Cubic Yards or IIIore ..
..............$40.00
...............$47.50
........$47.50
for the Erst 100 cube yards plus $10 50 for each
additional 1'JC cubic yards or fraction thereof.
..$1670<)
for the ftrst 1,000 cubic yards plus $9.00 for eae!'
additicn<!!1,000 cubic yards or fraction thereof.
......$27300
for the ftrst 10,000 cubic yards plus$40.50 for each
additior.al 10,0:')0 Cubic Yards or fraction thereof.
.......$66"5n
for the first 100,000 cubic yards plus $22.50 fo:
each ac.ditional 10,000 cubic yards or fractton
thereof.