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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 ntrniberad spaces only. <br />Job Address <br />Little Canada Mid Oaks <br />Legal Lot No, Sik. <br />1 Descr.Lot 6 & 10 Blk 1 <br />Nc -1073 <br />Bldg, Permit No. <br />Tract <br />Owner Mailing Address Zip <br />2 Ronald E. Palmen 1522 Albany Ave. St. Paul Mn 55108 <br />Applicant Meiling Address <br />3 same <br />Architect or Eng. Meiling Address <br />4 Professional Engineering Consultants <br />Contractor <br />5 <br />6 <br />1? P —Pa lman <br />Purpose of Fill or Excavating <br />Soti CnrrertiOn <br />Sae Attached Sheet <br />Phone <br />644 -4469 <br />Zip Phone <br />Zip <br />Little Canada <br />Mailing Address Zip <br />r- 1522 Albany Ave. St.Paul, Mn. <br />Phone <br />Phone <br />644 -4469 <br />Type and Amount of Fill or Excavating <br />7 Compactable Fill <br />Special Conditions <br />PERMITFEE$ 117.Q0 <br />NOTICE <br />This permit becomes null and void If filling or grading authorized Is not <br />mmplatad within 180 days, or if filling or grading is suspended or <br />abandoned for a period of 180 days at any time after work is cam. <br />menced. Any work not completed within 180 days requiresa new permit. <br />I hereby certify that I have read and examined this application and <br />know the same to be true and correct. All provisions of laws and <br />ordinances governing this type of work will be complied with Whether <br />specified herein or not. The granting of a permit does not presume to <br />give authority to violate or cancel the provisions of any other sate or <br />local law regulating filling or grading. <br />S1d�t a.- ntrector or Au. prized Agent <br />Signature of •caner (If Owner Contractor) <br />Building Official <br />50 cubic yards or less $15.00 <br />51 to 100 cubic yards 22.50 <br />101 to 1,000 cubic yards — $22.60 for the first 100 cubic yards, <br />plus $10.60 for each additional 100 cubic yards or fraction thereof. <br />1,001 to 10,000 cubic yards $117.00 for the first 1000 cubic yards, <br />Plus $9,00 for each additional 1.000 cubic yards or fraction thereof. <br />10,001 to 100,000 cubic yards — $198.00 for the first 10,000 cuble <br />yards, plus 340,50 for each additional 10,000 cubic yards or fraction <br />thereof, <br />100,001 cubic yards or more — $802.50 for the first 100,000 cubic <br />yards, plus $22,50 for each additional 10,000 cubic yards or fraction <br />thereof. <br />Other Inspections and Fees; <br />1. Inspections outside of normal business hours $30.00 per hrl <br />(minimum charge —two hours) <br />2. Reinspection fees ascaesed under provisions of <br />Section 305 (g) $30.00 per hr1 <br />3. Inspections for which no fee is specifically indicated 830.00 per hr1 <br />(minimum charge — one-half hour) <br />10r the total hourly cost to the jurisdletion, whichever is the greatest. <br />This con shall Include supervision, overhead, equipment, hourly wages <br />and fringe benefits of the employees involved. <br />(Date) <br />8 -7 -96 <br />(Date) <br />( betel <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />WHITE — Inspector <br />CANARY— Customer <br />PINK — Office <br />Permit Validation Ck MO Cash <br />*--cal Fee Collected $ <br />Page 8 <br />