06-11-1991 Council Agenda - Laserfiche WebLink

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CITY OF LITTLE CANADA 515 East Little Canada Road / Little Canada, MN 55117 FILLING AND GRADING PERMIT APPLICATION Applicant to complete numbered spaces only. l's■P 1038 Job Address 54.1/4,v 414 C LAMS Bldg. Permit No. Legal 1 Descr, Lot No. Blk. Tract See Attached Sheet Owner Mailing Address Zip Phone 2 LtiA (NGY2 No Jets, 5. /`'76D0 -,Ar'k Avg - wantivft.Lll Mn) y /-2SS7 Applicant Mailing Address Zip Phone 3 ,5141411C Architect or Eng. 4 Mailing Address Zip Phone Contractor 5 WOO 6ivr' l2 i .4 m 2 Purpose of Fill or Excavating ,r✓Q /n-6 s 6 Mailing Address Pi teed 6 G e �.p �� r--� Zip Phone 0— ^4.y-Z OQ�A.tV1v f LI- ,Mw `131 ^75-= ^% Type and Amount of Fill or Excavating 7 ielly,2 3a o Special Conditions �/ 8 PERMIT FEE $ NOTICE This permit becomes null and void if filling or grading authorized is not completed within 180 days, or if filling or grading is suspended or abandoned for a period of 180 days at any time after work is com- menced. Any work not completed within 180 days requires a new permit. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating filling or grading. Signature of Contractor or Aut d Agent 50 cubic yards or less $15.00 51 to 100 cubic yards 22:50 101 to 1,000 cubic yards — $22.50 for the first 100 cubic yards, plus $10.5Ofor each additional 100 cubic yards or fraction thereof. 1,001 to 10,000 cubic yards — $117.00 for the first 1,000 cubic yards, plus $9.00 for each additional 1,000 cubic yards or fraction thereof. 10,001 to 100,000 cubic yards — $198.00 for the first 10,000 cubic yards, plus $40.50 for each additional 10,000 cubic yards or fraction thereof, 100,001 cubic yards or more — $562.50 for the first 100,000 cubic yards, plus $22.50 for each additional 10,000 cubic yards or fraction thereof. Other Inspections and Fees: 1. Inspections outside of normal business hours $30.00 per hr1 (minimum charge —two hours) 2. Reinspection fees assessed under provisions of Section 305 (9) $30.00 per hr1 3. Inspections for which no fee is specifically indicated $30.00 per hr1 (minimum charge — one -half hour) for the total hourly cost to the jurisdiction, whichever is the greatest. This cost shall include supervision, overhead, equipment, hourly wages and fringe benefits of the employees involved. (o ')-9/ (Date) Signature of Owner (If Owner Contractor) (Date) Building Official (Date) WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT WHITE— Inspector CANARY — Customer PINK— Office PAGE 21A Permit Validation Ck MO Cash Total Fee Collected $ By