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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 />IN? 1037 <br />Job Address <br />Bldg. Permit No. <br />Legal <br />1 Descr. <br />Lot No, Blk. Tract <br />9 2 Bloomquist Lakeside Addition <br />See Attached Sheet <br />Owner Mailing Address Zip <br />2 Ely & Yvonne Arcilla 2735 Chisholm Ave. NO.St.Pd,ul, 55 <br />Phone <br />109 770 -5138 <br />Applicant Mailing Address <br />3 (same as line 2 above) <br />Zip <br />Phone .19 a —13 tz r— <br />Architect or Eng. Mailing Address Zip ` 1 <br />4 Braun Engineering Inc. 245 Roselawn Ave. E. St. Paul <br />Phone <br />487 -3245 <br />Contractor Mailing Address Zip <br />5 R &S Metro Trucking & Excavating Inc., Marine, MN <br />,d Phone <br />433 -5947 <br />Purpose of Fill or Excavating <br />6 Site preparation for home construction <br />Type and Amount of Fill or Excavating <br />7 Granular material, 2,000 cu. yds. <br />Special Conditions <br />8 The finished grade will be approximately 30" above existing grade to <br />keep it at the same elevation as the adjacent property on 647 Keller <br />Parkway owned by Chris Cardinal. This work is identical to the work <br />covered on the recently- issued fill permit to Mr. Cardinal. <br />PERMIT FEE $ <br />NOTICE <br />This permit becomes null and void if filling or grading authorized is not <br />completed 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 com- <br />menced. Any work not completed within 180 days requires a 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 state or <br />local law regulating filling or grading. <br />50 cubic yards or less $15.00 <br />51 to 100 cubic yards 22.50 <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 />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 />10,001 to 100,000 cubic yards — $198.00 for the first 10,000 cubic <br />yards, plus $40.50 for each additional 10,000 cubic yards or fraction <br />thereof. <br />100,001 cubic yards or more — $562.50 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 hr1 <br />(minimum charge —two hours) <br />2. Reinspection fees assessed under provisions of <br />Section 305 (g) $30.00 per hr1 <br />30.00 per hr1 <br />3. Inspections for which no fee is specifically indicated. $ <br />(minimum charge —one -half hour) <br />for 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 />Signature of Contractor or Authorized Agent <br />(Date) <br />Signature of Owner (If Owner Contractor) <br />(Date) <br />Building Official <br />(Date) <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />WHITE— Inspector <br />CANARY— Customer <br />PINK — Office <br />Page 23 <br />Permit Validation Ck MO Cash <br />Total Fee Collected $ <br />By <br />