Permit # / FORM #8
Return this document to City Hall
Receipt #

Grading Permit Application

This form becomes a "permit" when city staff issues a permit number. If you prefer to complete this form electronically, it is available at www.greenwoodmn.com.

Property Owner(s)
Property Address

Person completing this form: Grading Contractor Property Owner Builder / Architect

This sheet is accompanied by a Building Permit Application (Form #1): Yes (skip to section 2) No (complete section 1)

SECTION 1

Date Application Submitted
Property Owner's Mailing Address
Property Owner's Phone Number
Property Owner's Email
Contractor or Builder / Architect Name
Contractor or Builder / Architect Address
Contractor or Builder / Architect Phone
Contractor or Builder / Architect Email

SECTION 2

Total surface area to be moved, disturbed, cut, or filled (square feet)
Total volume of soil or earth to be moved, disturbed, cut, or filled (cubic feet)
Estimated start date

Work is required for: Remodeling of an existing structure Construction of a new structure Other:

Work is due to circumstances not related to the land or existing drainage issues, but due to an election by the property owner to make an addition to a principal or accessory structure: Yes No

The average elevation of the land will increase / decrease by: Less than 1ft

1ft or more in a 100+ sq ft area (city engineer approval required) 2ft or more in a 300+ sq ft area (variance required)

Per code section 1140.19 subd 3, the following items must submitted with this application:

(1) Survey (2) Stormwater Management Plan prepared by a civil engineer

The undersigned hereby submits this application (including a survey and Stormwater Management Plan) for a grading permit and certifies the information provided on this permit application is true and correct to the best of my knowledge. The property owner(s) listed above are the sole fee title owner(s) of the described property; information provided on this application and submitted documents is true, complete and accurate; if the application is approved, the work will be in accordance with the application and city code section 1140.19 (view at www.greenwoodmn.com or at city hall).

Signature / Date:
Print Name

This section completed if grading is NOT in conjunction with a building permit:

For Office Use Only / Fee Amount $ / Fee Paid: Cash Check # / Date Pmt Received:

Form Updated 10-27-14