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<br />Lot:al.ioll or Properl.y:
<br />Legal DC!lcripti'lIl;
<br />liill I.hl~ excllval.ion 01' rill ill:'; be in a: IYal."I'I,,-,ul'!lp._lvf!L1and_lJlilancl_
<br />PUI'plH;e fnl' Lh(, P.'olloseu excavating or ri 11 ing:
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<br />CIH OF F.I.I; 1.ln:l.
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<br />APPf. rCI\TTON FOR
<br />KXr.,WATlNG/Frr.l.rNG rmmT
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<br />Pel'HI i L No.
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<br />Oal.l'_/_/_
<br />Phoneli
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<br />ApI'] iean t
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<br />PI'opel'l.y Owner;
<br />Address;
<br />COIII.I'a(;l.ur:
<br />,\chll'ess:
<br />Consultant Engineer/Survp.yol'
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<br />Phone#
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<br />Phone#
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<br />".. I. i mal.ml s tal'\. dat.e;
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<br />Cl.Impl.,l.ion dat,,:
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<br />Whnl. is LIllI I.ype of mal.et'inl 1.0 he 1"lmOV,!d 0" d,'p,'sil...d:
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<br />lu whal. manlier will. the mal,!rial be I'emov,ld alld/o.' deposit.ed?
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<br />WhaL hi~hwny, sLreet, or nUll'" puhlil: I;I\~' "i.ll matt'rial fOl' removal 01'
<br />der/osi tatioli be h:wled 01' cardell':'
<br />!ihaL, if any, street, aVP.lllle, lau., alley, highway, right of way,
<br />thoroughfarc 01' vublic grounu wi I I hE' ohsl.t'ucl.ed':'
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<br />IT SHM.L BE THE RES PONS TIn L IT'" ;\ND TilE BURDEN OF THE APPLI CANT TO
<br />DEMONSTRIITF. TO THE SATTSFM:TION OF TIIF. r.JTY mlTT.DING &. 7.ONING
<br />ADMINISTRATOR FOR THE CITY OF F.LI\ "HER TIL\T TIlE PROPOSED EXCAVATION
<br />MiD/OR FIr.LING COMPLIES IvITII TilE l\prr.ICAnLF. CITY ORDrN,\NCES OF ELK RIVER.
<br />SAID RIIRDF.N SHALL INCLUDF. TIlE FllRNISHIi';r. OF ,\ RF.PORT lHTH SUPPORTING
<br />CAI.CULATIONS OF A REGISTERED PROFESSIONAl. F.NI-;TNF:ER, IF RF.QUIRF.D.
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<br />SlJRmSSION REQUIRF.MKNTS;
<br />I.i me 0 f apld i CIl Li on a I.
<br />,\dmj n i stn1tor' ,
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<br />TIll"
<br />t.he
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<br />fllllo\4illg it.f!nl!,; !lhall hI" submitt.eu al. t.he
<br />di!';c:!'et.ion of I.ht! Building and Zoning
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<br />(,\) ClIOIpl,'(yd al'l'l icaLioll fo/'m (n) (;onl\oI"t.e" l"gal description (r.) Map 01"
<br />I'lal. of I.he PI'ol,,',sed fi lJing or excavating !lhowing locat.ion and amoullt of
<br />mal.l!,'jal p,'oposlld 1.0 be I"cmllved 01" delmslt.ed, wi th a description of l.he
<br />a/'N1 (0) Tlte depth or heighl.s t.o which SIICIt reOloval or deposi t.ion is
<br />I""opo!l<'ld I.h/'ougll the area and t.he proposed 11IIS 1 e nf all slopes to be shown
<br />011 a 2' COli Lou I' map at a scale of I" = ;'0' 0" ];lI"gel': The proposed and
<br />Ilf'igill:il <:nIlI.OIlI'S shall he 5ltO"" inclllding al 1 IH"OI"'I't.~, withill 1;'0' of
<br />11I'ol'us..d pxcavaLion 01' deposition an" slmll I,," siglled hy an engi/H~p.r 0/"
<br />SIII'VCY,'!' I'egisl..:.";.:tl in U,e Sl.al.e of ~Iinne!lnl.a (E) F.1'I)sion control plan (F)
<br />Afr,",1. Oil .,xi5I.ing utili!.i!'s (G) Prol.t'C"Liun of site hy erection of
<br />!ll/it.ahle f.~nce, guarcl 01' harl'icnde (H) AppTical.inll fIle (I) Bond, l,~tl.el" of
<br />C1'l'dit, 'iI" d'~i'osit of moni,'!; in a 5um suffici'~1I1. 1.0 pay t1lf! CO!lI. of
<br />l'esL(trin~ a si.l.e. The ,',;d.I'a o!'dinary cnsl.s of ,'epairing, highway!';,
<br />l'1.1'''l'I.l' or' oU",r" pl/bl ic l>ays ah,jlg d,'sigllat..t1 ['ol/t.es of travel Ilnd 1.0 pay
<br />SIlCIt ex 1l'-llsr,s lI!. the C i l.y lIIay i IICll r' by J'eal>O" II f do i rog any Lit j ng rp.'l" i I'cd
<br />tu I.., donp. (,T) Public liaiJilil.~' inslll':lIlCO.'.
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<br />,\mOlln L (I r bond
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<br />Lel.l.el' of en~di I.,
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<br />Ii aL i Ii t~. i lI!;ur'ance prov i ..ed
<br />Siglrlll.lIl'e (If apr,] ican!.
<br />P",'mi I. dl'(lIll'i I.
<br />Hili hlil'S &. loning Arlministr'lltol'
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<br />or deposit. uf money
<br />Pe,'m it fee
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<br />DaLe
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<br />Dat.e
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