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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 />INT? 1023 <br />Job Address Bldg. Permit No. <br />401 East Viking Drive Little Canada, Mn. 55117 <br />Legal Lot No. elk. Tract <br />1 Descr. 08 29 22 32 0005 9 See Attached Sheet <br />Owner Mailing Address Zip Phone <br />2 Ronald E. Palmen 401 East Viking Dr. Little Canada, Mn. 55117 483 -9537 <br />Applicant Mailing Address Zip Phone <br />3 same same same <br />Architect or Eng. Mailing Address Zip Phone <br />4 E. G. Rud & Sons, Inc. 9560 Lexington Ave. No. Circle Pines, Mn. 786 -5556 <br />Contractor Mailing Address Zip Phone <br />5 R. E. Palmen, Inc. 401 East Viking Dr. Little Canada, Mn. 483 -9537 <br />Purpose of Fill or Excavating <br />6 Preparation for home sites. <br />Type and Amount of Fill or Excavating <br />7 Sand for pads for homes. <br />Special Conditions <br />8 <br />117.00 50 cubic yards or less $15.00 <br />PERMIT FEE $ 51 to 100 cubic yards 2230 <br />101 to 1,000 cubic yards — $22.50 for the first 100 cubic yards, <br />plus $10.50 for each additional 100 cubic yards or fraction thereof. <br />NOTICE 1,001 to 10,000 cubic yards — $117.00 for the first 1,000 cubic yards, <br />plus $9.00 for each additional 1,000 cubic yards or fraction thereof. <br />This permit becomes null and void if filling or grading authdri, ' po ,y 10,001 to 100,000 cubic yards — $198.00 for the first 10,000 cubic <br />completed within 180 days, or if filling or gradings,it'§uspehde nor + ^` yards, plus $4050 for each additional 10,000 cubic yards or fraction <br />abandoned for a period of 180 days at any time 34.1. w8t,./ 4,tbm- �': :, thereof. <br />" ^' "'ttik r: 100,001 cubic yards or more — $562.50 for the first 100,000 cubic <br />menced. Any work not completed within 780.x,�j., r. j4?tet`�'new permit. <br />'lu i C • yards, plus $22.50 for each additional 10,000 cubic yards or fraction <br />I hereby certify that I have read and ecin{utdd this applicat\'or1 A 5 thereof. <br />know the same to be true and correct.`A4'proviA!erclof la s and Other Inspections and Fees: <br />ordinances governing this type of work wilt.blbcom ig with whether 1. Inspections outside of normal business hours $30.00 per hr1 <br />specified herein or not. The granting of a permit does not pres9rt b P (minimum charge —two hours) <br />give authority to violate or cancel the provisions of any o ei ita , .N..) <br />local law regulating filling or grading, cf+.t" 2. Reinspection fees assessed under provisions of <br />�\>rE Section 305 (g) $30.00 per hrt <br />3. Inspections for which no fee is specifically indicated$30.00 per hri <br />(minimum charge —one -half hour) <br />1or the total hourly cost to the jurisdiction, whichever is the greatest. <br />This cost shall include supervision, overhead, equipment, hourly wages <br />and fringe benefits of the employees involved. <br />U._.) az.(6u — ) 9 -8 -5'Y <br />Signature of Contractor or Authorized Agent (Date) <br />- Lc..Lr:_, et, .Oa.e ..-/ 9 -if -aq <br />Signature of Owner (If Owner Contractor) (Date) <br />Building Official (Date) <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />WHITE— Inspector <br />CANARY — Customer <br />PINK — Office <br />PAGE -16- <br />Permit Validation Ck MO Cash <br />Total Fee Collected $ <br />By <br />