Excavation, Fill & Grading Permit Application

Excavation, Fill & Grading Permit Application
Applicant & Project Information
Property Owner*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Excavator's Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Contractor's State License Number*
Address of Project Site*
Size of Subject Property*
Amount of Excavation, fill or grading (in cubic yards)*
Estimated Improvement Cost*
Estimated Start Date*

MonthDayYear
Date
Estimated Completion Date*

MonthDayYear
Date
Description of the Project*

Supporting Materials

The following materials are required to be submitted with the application:
1. Ownership Affidavit: A notarized affidavit stating that the application is the owner, the equjtable owner, or authorized by the owner in writing to make application of the excavation, fill or grading permit shall be submitted. This application will be accepted as an ownership affidavit if it is notarized.
2. Contractor's license: Proof of a contractor license shall be submitted.
3. Traffic Control Plan: A traffic control plan detailing how traffic will be controlled during the construction shall be submitted in accordance with the City Construction Specifications. Further notice must be given to the Sheriff & Fire Departments informing them when the traffic control plan will be in effect.
4. Legal Description: A legal description of the proposed development property boundaries shall be submitted.
5. Site plan: One large (24" x 36") & one reduced (11" x 17'') copies of the site plans drawn to scale showing the significant, natural, & man-made features on the site & within a¼ mile of the project shall be submitted. The site plan shall also show the proposed location of the sewer lines & points of connection, or location of septic system along with a map showing all utilities within 100' of work.
6. Slope Analysis: One large (24" x36") & one reduced (11" x 17") copies of the sites topography shall be submitted if the predominant slope of the property exceeds five (5) percent with contour lines showing topographic intervals of not more than two (2) feet.
7. Engineering Plan: Two copies of the engineering plans showing profiles shall be submitted.
8. SWPPP: Two co pie of storm water pollution prevention plans shall be submitted.
9. Soil Report: Two copies of the soil reports shall be submitted.
10. Improvement Bond: An engineering cost estimate for the proposed work shall be submitted & verified by the City Engineer. An improvement bond in the amount of a 110% of engineering cost estimate shall be posted.
11. Fees: The payment of a grading permit fee in the amount determined by the City Engineer according to The Con olidated Fee Schedule along with any other applicable fees.
12. As-Builds: As-builds must be provided to the City prior to the release of the improvement bond.
Applicant Certification
I certify under penalty of perjury that this application & all information submitted as a part of this application are true, complete & accurate to the best of my knowledge. I also certify that I am the owner of the subject property & that the authorized agent noted in this application has my consent to represent me with respect to this application. Should any of the information or representations submitted in connection with this application be incorrect or untrue or if conditions of the approval are not followed, I understand that The City of Eagle Mountain may rescind any approval, or take any other legal or appropiate action. I also acknowledge that I have reviewed the application sections of the Eagle Mountain Development Code & that items & checklists contained in this application are basic & minimum requirements only & that other requirements may be imposed that are unique to individual projects or uses. Additionally, I have reviewed & understand sections from the Consolidation fee Schedule. I also agree to allow the staff, Planning Commission, or City Council or appointed agent(s) of the City to enter the subject property to make any necessary inspections thereof. I also understand that the approval of a minor development permit is valid for one year from the date of approval unless a longer duration is specified in a development agreement.
Property Owner's Signature*

Clear
Today's Date
ADA Signature (If Applicable)

Agree to CertifyDisagree to Certify
OFFICE USE ONLY
Fees Received By:
Date of Submittal

MonthDayYear
Date
Amount Paid
Receipt Number
Engineering Approval

Clear
Today's Date
Should be Empty:

Excavation, Fill & Grading Permit Application

Applicant & Project Information

Supporting Materials

Applicant Certification