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CITY OF LITTLE CANADA <br />515 East Little Canada Road / Little Canada, MN 55117 <br />FILLING AND GRADING PERMIT APPLICATION <br />Applicant to complete numbered spaces only. <br />N? 1092 <br />Job Address Bldg. Permit No. <br />x y ,— r �- -� J2/� <br />Legal Lot No. Mk. Tract <br />1 Descr. See Attached Sheet <br />Owner Mailing Address Zip Phone <br />li 571e .8sC/tt -s-6 _ y6-5 et-,'• cy 437/7 9t3 7 7r4"2 <br />Applicant Mailing Address Zip Phone <br />3 /j'' (441 ^i. <br />Architect or Eng, Mailing Address Zip Phone <br />4 <br />Contractor Mailing Address Zip Phone <br />5 <br />Purpose of Fill or Excavating <br />xType and Amount of Fill or Excavating <br />/o ff CA-00 7 c r_JJ <br />Special Con itions <br />8 <br />Z - -- 5o s 1D� 51 cubic -rds or less $1 ,50 <br />PERMIT FEE $ � � r 00 J `.Rl hf� 51 to 100 C. •ic yards <br />.50 <br />101 to 1,000 c• •ic yards — $22.50 for the first 100 cubic yards, <br />rr�— plus $10.50 • each additional 100 cubic yards or fraction ereof. <br />NOTICE 2J, 1,001 to 10,000 cu:' yards — $117.00 for the first 1,000 c •ic yards, <br />plus $9.00 for eac additional 1,000 cubic yards or fra• ion thereof. <br />This permit becomes null and void if filling or grading authorized is not 10,001 to 100,000 cubi ards — $198.00 for the first 1 .,000 cubic <br />completed within 180 days, or if filling or grading is suspended or yards, plus $40.50 for •'ch additional 10,000 cub' yards or fraction <br />abandoned for a period of 180 days at any time after work is cam- thereof. <br />menced. Any work not completed within 180 days requires a new permit. 100,001 cubic yards or more — •.562.50 for the f. st 100,000 cubic <br />yards, plus $22.50 for each a••'tional 10,0te cubic yards or fraction <br />I hereby certify that I have read and examined this application and thereof, t._, <br />know the same to be true and correct. All provisions of laws and Other Inspections and Fees: / <br />ordinances governing this type of work will be complied with whether 1, Inspections outside of normal bu ass •urs $30.00 per hr1 <br />specified herein or not. The granting of a permit does not presume to (minimum charge —two hours) <br />give authority to violate or cancel the provisions of any other state or <br />local law regulating filling or grading. 2. Reinspection fees assessed •nder provisions • <br />Section 305 (g) $30.00 per hr1 <br />3. Inspections for whi. no fee is specifically indicated $30.00 per hr1 <br />(minimum chary •ne -half hour) <br />tar the total ho ly cost to the jurisdiction, whichever t the greatest. <br />This cost shall nclude supervision, overhead, equipment, hourly wages <br />and fringe be fits of the employees involved. <br />PAID <br />Signature of Contractor or Authorized Agent (Date) <br />--eC t 7 ` =--- -- - -' $131g`l AUG - 3 1999 <br />Signature of Owner (If Owner Contractor) (Date) <br />CITY OF LITTLE CANADA <br />Building Official (Date) <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOURJRMIT <br />WHITE—Inspector <br />CANARY — Customer <br />PINK — Office <br />Permit Validation <br />Page 111 <br />