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Proposed Grading: Square Footage of Activity: X $0.015/sqft = Administrative Fee: $250.00 FEE Import □ Export □ Neither □ INFORMATION FOR THE APPLICANT: A Grading permit is required if you are disturbing more than 300 cubic yards. (Equivilant to approximately 20 tandem dump trucks) MANDATORY FOR ALL WORK AREAS AFFECTING MORE THAN 1 ACRE: A Stormwater Discharge permit COR400000 must be obtained from the CO CDPHE. Information for this permit can be obtained at or [PHONE REDACTED] MANDATORY FOR ALL WORK AREAS AFFECTING MORE THAN 1 ACRE: A site plan with a brief narrative of work to be done. 1. To the best of my/our knowledge, the information provided herein is correct; 2. The Grading Permit is granted with the explicit understanding that it is the Applicant's' responsibility to: 1. 2. 3. Owner's Signature Contractor Signature Date Date Staff Approval □ Yes □ No Signature Date ELBERT COUNTY APPROVAL Final Inspection □ Yes □ No Signature Date COMMERCIAL GRADING PERMIT APPLICATION Permit GRADING PERMIT Elbert County Public Works Department P.O. Box 116, 215 Cheyenne St., Kiowa, CO 80117 Ph: [PHONE REDACTED], Fax: [PHONE REDACTED] Revision Date: 12/19/18 Completed application can be emailed to [EMAIL REDACTED] Date: Contractor Name: Property Owner: Contractor Address: City/State/Zip A Grading Plan for the disturbed area on this site was prepared and submitted in accordance with the current Elbert County Construction Standards and Specifications Manual. I certify I am legally authorized to sign on behalf of and bind the above-listed entity. By signing below, the property owner and the property owner's contractor hereby apply for an Elbert County Grading Permit for the above mentioned property and certify as follows: Address: Phone: Contractor Phone Allow Elbert County unrestricted access to the site to conduct regular site inspections and be in compliance with all the requirements of the Elbert County Construction Standards and Specifications Manuel and Grading Permit. Immediately cease land-disturbing activities upon receipt of a written Stop Work Order from an authorized representative of Elbert County. If a Stop Work Order is issued, this permit will be revoked if the applicants are not in compliance with the Elbert County Grading Permit and Construction Standards and Specifications Manuel or if the applicants fail to take corrective action within the time specified on the written notification of such non-compliance. Understand that any approval obtained by the Elbert County DPW does not negate your need to comply with the requirements of the State of Colorado Department of Public Health and Environment, Colorado Discharge Permit System, General Permit, and Sections 7 and 9 of the Endangered Species Act of 1973, 16 U.S.C. 1531, et seq., as amended, or with any other applicable federal, state or local laws or regulations. Project Address: Email: Subdivision: