CITY of NOWTHEN City Hall : 763-441-1347 Bldg Dept : 763-274 -2311 Fax : 763-441-7013

EXCAVATING / MINING PERMIT APPLICATION

As per City of Nowthen Ordinance # 4 – Excavation and Mining; ---“ it shall be unlawful for anyone to operate a mine or excavate without having first obtained a written permit from the city authorizing the same in accordance with ordinance.”

SITE ADDRESS OF PROPOSED OPERATION: ______

LEGAL DESCRIPTION / PIN # : ______

PROPERTY OWNER: ______PHONE # ______

PROPERTY OWNER ADDRESS: ______

PURPOSE OF THE OPERATION: ______

TOTAL CUBIC YARDS OF MATERIAL TO BE EXCAVATED: ______

********************************************************** An application for excavation of 101 cubic yards to 1000 cubic yards requires an EXCAVATION PERMIT. An application for mining of 1001 cubic yards or more requires a MINING PERMIT and must include all the items listed in Ordinance # 4, Section 202 – Content of Application (which are listed below) ---

(use separate sheet of paper for those items that require additional information)

Letters from: Army Corps of Engineers , MN Dept. of Natural Resources and Anoka Conservation District , stating that the proposed project is acceptable.

Names and addresses of all landowners owning property within 1,320 feet of the boundary of the property described above.

Description of the potential impact to adjacent properties.

Soil borings sufficient to approximate the number of yards that will be removed.

Material to be permanently placed on site. Material will be removed from site. Provide map of travel routes to and from the site. Provide plans for drainage, water erosion control, sedimentation, and dust control.

Rehabilitation / restoration plan provided for the orderly and continuing rehabilitation of all disturbed land, (using photographs, maps and surveys, where appropriate).

A statement identifying the applicant’s program to ensure compliance with the permit conditions, method of response to complaints, and resolving conflicts that may arise as a result of complaints.

Site plan indicating overall dimensions of excavation, side slopes, depth and elevation views. 2

Comments: ______

**********************************************************

APPLICANT: ______DATE: ______Signature BLDG. OFFICIALS APPROVAL: ______DATE: ______

PERMIT FEE COLLECTED: ______RECEIPT ______DATE: ______