Laserfiche WebLink
<br />. <br /> <br /> <br />APPLICATION FOR FENCE OR RETAINING WALL PERMIT <br /> <br />JOB ADDRESS <br /> <br />Project Valuation $ <br /> <br />Is this pennit for a fence or retaining wall? <br /> <br />Owner's Name <br /> <br />Day Telephone <br /> <br />General Contractor <br /> <br />Address <br /> <br />City <br /> <br />State <br /> <br />Zip <br /> <br />Telephone <br /> <br />License Number (note: all contractors/subcontractors must be city or state licensed) <br /> <br />TO BE SUBMITTED: Plot Plan/Certificate of Survey <br />Type ofFenceJRetaining Wall Material <br /> <br />(showing all easements) <br />Height <br /> <br />Approximate Starting Date <br /> <br />Approximate Completion Date <br /> <br />ignature <br /> <br />Date <br /> <br />DO NOT WRITE BELOW THIS LINE <br /> <br />Type of Construction <br /> <br />Occupancy Group <br /> <br />Division <br /> <br />Use Zone <br /> <br />Survey: Required <br /> <br />On File <br /> <br />N/A <br /> <br />Permit $30.0Q State Surcharge $0.50 Easement Encroachment Agreement $30.00 License Verification $5.00 <br /> <br />TOTAL AMOUNT DUE $ <br /> <br />...-....-.................-..................-.....-....--.....-.....-..................................................._-..........-..................-................... <br /> <br />Review By: <br /> <br />Date: <br /> <br />Issued By: <br />Permit # <br /> <br />Date: <br /> <br />600 Town Center Pmkway, Lino Lakes, Minnesota 55014-1182 <br />'RnilrliounP1"UlrtmP.nt" h~1..()sc.')_'4,)O. F~y' ,;,1..QSt??4QQ <br />