Land Alt Effective November 20, 2007
Receipt#
Fee: $
CITY OF FRIDLEY
LAND ALTERATION PERMIT
APPLICANT a 1Tel.# ��c� ' �� — l L��
Address
PROPERTY OWNERS �
NAME �C �2 Tel.# (/
G
Address !o� 1 1 TTZ� ����-�.•
NAME Tel.#
Address
LEGAL DESCRIPTION OF PROPERTY
Lot Block Addition
Address 4G ( C q3�-
DESCRIPTION OF LAND ALTERATION
Value of Work: $ W-- Starting Date: 2,= Completion Date:
Source and Composition of Fill:
Gam;Vl� C&-nn e4- Go
4-c� �� i I A6-4d St-o
PURPOSE OF LAND
ALXTION
d
w
ATTACHMENTS TO APPLICATION
The following plans, drawings, calculations, bonds and/or statements may be required by the Public Works
Department:
[] Half-section map or sketch of properly showing all adjacent property indicating the existing buildings and/or
structures.
[] Grading plan showing existing and proposed finished contours and evaluations.
[] Drainage plan showing existing and proposed drainage structures,stabilization walls,retaining walls,cribbing,
dams,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 of potential 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
residents and the 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,.51),
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.
S. 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.
L*'
kcae Date:
A 'cant's Signature
Date:
Property Owner's Signature
Date:
Property Owner's Signature
FOR CITY USE ONLY
Recommended for Approval By: Date:
Approved By: Date:
PERMIT EXPIRATION DATE:
1
City of Fridley
6283 , 14 CivicSight Map
7— 0 � 6282 6283
6271 1 "7`" /� PARCEL INFORMATION:
1400 6274 PIN-r Info: 430072
Owner Info:
Name 1-BATESON GEORGE F 8 ANN L
6275 62 Name 2_
Owner Address-8198 HEATHER PLACE
OwnerCSZ-FRIDLEY,MN 55432
6245 N �� Site Address-6229BEN MOORE
ORS NE
Legal Description:THEE 300 FT OFF LOT 19 AUD SUB NO
'A 1 6 22 SUBJ TO EASE OF RECORD
O MAP LEGEND:
�':/r %' �,/��/� // ❑
CITY UWTS
6244 WATER
6229 � i;, ,,,;,,, �, PARCELS
�,.
Q cs
' o w 6240
N
C� ,
0 0 o c-v 6 09 i-21 t4 > '� f' 1 acc��'
w cr c� 6236 ,��
61 1411
6.190 6196
618500
2 6187 ->
6175 1400 ,� n,
6172 6177 0 6171Uj cc
1410 6170 a
6160 �C
M127
T— (,��- 6115 Reference Map
`V
r.w o 6150
Map Scale:1 inch=161 feet
//0 6105 Map Date:6/01/2009
OD
Data Date:February
19,2009
Sources:FRIDLEY GIS
1 460-V4 g3 ANOKA COUNTY ASSESSOR'S OFFICE
Disclaimer.
opydght®2006-RWers Edge GIS,LLC.