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LmuicantiUc
<br />M200WAppificant Type: omeowner ❑ Contractor; License #
<br />Company Name (contractors only):
<br />Mailing Address: City/Sta
<br />OA
<br />Contact Name: Contact Phone Number: Contact Fax Number:
<br />` Reason for Work: ❑ Alter
<br />Describe Work and List All Special Approvals or Details of this Project:
<br />too
<br />EN HWLLS
<br />Z09
<br />.. 1245 W Hwy 96 * Arden Hills MN 55112
<br />A site drawing showing the driveway or fence location
<br />Phone 651.792.7800 * Fax 651.634.5137
<br />www_c7t.arden-hills_mn.us
<br />ZONING PERMIT APPLICATION
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<br />i
<br />operty Type: ❑ Residential ❑ Commercial ❑
<br />-
<br />Occupancy Group:
<br />Public
<br />$15 for first 100 lineal feet + $6 for each $
<br />additional or fraction thereof
<br />construction or work is suspended or abandoned for a period of 180
<br />days at any time after work has commenced. By signing this
<br />Pro e 'Address:
<br />p `
<br />'`)
<br />application, you hereby certify that you have read and examined this
<br />For Office Use Only)
<br />application and know the same to be true and correct_ All provision of
<br />7
<br />Bldg /Suite/Location commercial proiects only):
<br />_
<br />presume to give authority to violate or cancel the provisions of any other
<br />Owner Naris
<br />Owner Phone Number.
<br />Applicant is responsible for all plan check fees if permit is cancelled or
<br />4 �1 — 61 3
<br />Mailing Address-
<br />ddress-17.7 �-�' ? �„ o ,
<br />177
<br />_ -_
<br />City/State/Zip:
<br />LmuicantiUc
<br />M200WAppificant Type: omeowner ❑ Contractor; License #
<br />Company Name (contractors only):
<br />Mailing Address: City/Sta
<br />OA
<br />Contact Name: Contact Phone Number: Contact Fax Number:
<br />` Reason for Work: ❑ Alter
<br />Describe Work and List All Special Approvals or Details of this Project:
<br />❑ New ❑ Remodel ❑ Repair
<br />Driveway Square Footage/Fence Lineal feet (round up): Expected gomZple ion Date:
<br />A site drawing showing the driveway or fence location
<br />on the property in relation to of er structures
<br />and dimensions must be included with this application.
<br />IMPORTANT NOTICE. Applicant must attach a site plan for all
<br />Permit Fee — Driveway
<br />applications. There is a 10 working day turnaround for all P ermits
<br />$18
<br />add for firstitionalor fractIncl sq.ft.ion ther $6 for each $
<br />.addreof
<br />requiring plan review_ Call for a final inspection upon completion of the
<br />work described. This permit becomes null and void if work or
<br />Permit Fee —Fence _
<br />construction authorized is not commenced within 180 days, or if
<br />$15 for first 100 lineal feet + $6 for each $
<br />additional or fraction thereof
<br />construction or work is suspended or abandoned for a period of 180
<br />days at any time after work has commenced. By signing this
<br />License $30 $
<br />Coe)
<br />f
<br />application, you hereby certify that you have read and examined this
<br />(if applicable) (annual fee)
<br />applicable) (
<br />application and know the same to be true and correct_ All provision of
<br />laws and ordinances governing this type of work will be complied with
<br />whether specified herein or not. The granting of a permit does not
<br />_
<br />presume to give authority to violate or cancel the provisions of any other
<br />state or local law regulating construction or the performance of
<br />construction_ Applicant takes full responsibility for all work performed.
<br />Applicant is responsible for all plan check fees if permit is cancelled or
<br />withdrawn,
<br />P
<br />TOTAL PERMIT FEE►
<br />Applicant Si natu r Date
<br />Ll
<br />Application Complete - C�?
<br />Date
<br />Approval, Specia#,Conditions
<br />❑ Denial, Reason for Denial:
<br />Revi
<br />ast Revised lVo�ember 2008
<br />
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