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2. 
4. GRADING AND FILL PERMIT
6. This permit is to allow for fill placement, grading or otherwise disturbing the surface of a property independent of a building permit.

   Submittal Requirements are the following: 

   (1) A grading plan or location map showing the general location and configuration of fill or grading. 
   (2) Indicate quantity of fill. 
   (3) An erosion control plan that includes a stabilized construction exit and sediment control around the perimeter.
   (4) A permanent stabilization plan including a note that if fill is not planned to be distributed within 14 days, fill must be immediately permanently stabilized. A NOI/site notice will be required if the disturbed area is larger than one acre.
   (5) Map showing haul route from pickup location to site.
   (6) If fill is within FEMA Floodplain, a floodplain development permit is required. (Attach a link of Floodplain Permit) 
   (6) Note: Additional information may be required. 

8. Project location / address*
10. Project subdivision / survey*
12. Project block*
13. Project lot*
15. Purpose / description of the grading / fill*
17. Is any of the work within a FEMA floodplain? *
    -- Select One --YESNO
18. If yes, please attach the City of Mansfield Floodplain Development Permit
20. CONTACT INFORMATION
22. Is the applicant the property owner?*
    -- Select One --YESNO
24. Applicant name*
25. Applicant address*
27. Applicant phone number*
28. Applicant e-mail address*
30. CONTRACTOR INFORMATION
32. Contractor name*
33. Contractor address*
35. Contractor phone number*
36. Contractor e-mail address*
38. Attachment
40. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 

    1)  You understand this application will take up to five working days to review and process.

    2) Your application will not be signed in the sense of a traditional paper document.

    3) By signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature.

    4) You may sill be required to provide a traditional signature at a later date.

    1. I agree.
42. Electronic Signature*
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

* indicates a required field