Fillable APPLICATION FOR GRADING AND EXCAVATION PERMIT (City of Jordan, MN)

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APPLICATION FOR GRADING AND EXCAVATION PERMIT (City of Jordan, MN)

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The APPLICATION FOR GRADING AND EXCAVATION PERMIT (City of Jordan, MN) form is 2 pages long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for City of Jordan, MN

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City of Jordan – Application for Grading & Excavation Permit Last Updated 8/27/2020 Page 1
APPLICATION FOR GRADING AND EXCAVATION PERMIT
CITY OF JORDAN
210 EAST FIRST STREET
JORDAN, MN 55352
952-492-2535
Site Information
Site Address: _________________________________________________________________________________
Legal Description: _____________________________________________________________________________
Applicant / Contractor Information
Name: ______________________________________________ Phone: __________________________________
Address: ______________________________________________ Email: _________________________________
Owner Information ([ ] Check if same as above)
Name: ________________________________________________ Phone: ________________________________
Address: ______________________________________________ Email: _________________________________
The applicant is responsible to obtain all grading and wetland permits that may be applicable to the project. This
may include permits from the Corps of Engineers, Minnesota Department of Natural Resources, Minnesota
Pollution and Control Agency. Copies of these permits shall be provided to the City prior to initiating grading
activities.
1. Development Name: _____________________________________________________________________
2. Name of firm preparing Grading and Erosion Control Plan: ______________________________________
Phone: ________________________ Address: ________________________________________________
3. Describe work applied for under this permit: _________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
4. Estimated cubic yards of material to be moved on site ______________ cu. yds.
5. Total acreage disturbed by grading: ________________ acres
6. Enclose two copies of the proposed mass grading plan showing existing and proposed final contours of
the site. The grading plan shall also indicate all erosion control facilities to be installed and maintained
during and following the grading operation. Any changes or deviations from approved plans require
that an amended permit be applied for and approved before the work is performed. For additional
requirements, see Chapter 150: Building Regulations SEC 150.06 of the Jordan City Code.
City of Jordan – Application for Grading & Excavation Permit Last Updated 8/27/2020 Page 2
The undersigned hereby agrees all work will be done in accordance with approved plans and all ordinances of the City
of Jordan.
I certify that all information submitted is true and correct.
Applicant Signature: ______________________________________ Date: _____________________
Owners’ Signature(s):_______________________________________ Date: _____________________
FOR OFFICE USE ONLY
DATE SUBMITTED: _________ DATE COMPLETE: ___________ IF INCOMPLETE, DATE LETTER SENT TO APPLICANT:
_______
FEE PAID: _________ DATE FEE PAID: ___________ FILE #_________
APPROVED _______ DENIED _______
BY___________________________________________________________________
DATE OF ACTION: ______________
DATE APPLICANT/PROPERTY OWNER NOTIFIED OF CITY STAFF ACTION: _________________
DATE PERMIT ADDED TO PROPERTY ADDRESS FILE.
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APPLICATION FOR GRADING AND EXCAVATION PERMIT (City of Jordan, MN)

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Completed 9 February 2021

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