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C I T <br />IN <br />APPLICATION FOR FENCE OR RETAINING WALL PERMIT <br />JOB ADDRESS / `2-)5 7-'10IN &AA/6- Project Valuation $ gg 00 <br />Is this permit for a fence or retaining wall? <br />Owner's Name Mikz -Tai <br />General Contractor <br />Day Telephone -71,3 -35u, <br />F Address <br />E -mail Address fl) a'v5e .e 44 -1—) �ru <br />City State Zip Telephone <br />License Number (note: all contractors /subcontractors must be city or state licensed) <br />TO BE SUBMITTED: <br />• Plot Plan /Certificate of Survey (showing all easements and dimensions of fence from principal building or <br />home). Please note that retaining walls are not allowed in easements. <br />Type of Fence /Retaining Wall Material <br />Approximate Starting Date I (o/ 20/1 <br />Signature <br />/gyp` wood.1 I vy Height t',7. (4,0o4i, (f'c..14't;'' <br />Una6J�,� <br />Approximate Completion Date g I/ 312 )1 <br />Date <br />DO NOT WRITE BELOW THIS LINE <br />Type of Construction Occupancy Group <br />Division Use Zone <br />Permit $50.00 Easement Encroachment Agreement $55.00 License Verification $5.00 <br />TOTAL AMOUNT DUE $ <br />Engineering Approval: Note: <br />Review By: Date: <br />Issued By: Date: <br />Permit #�/ ,0 c <br />600 Town Center Parkway, Lino Lakes, Minnesota 55014 -1182 <br />Building Department: 651- 982 -2420 • Fax: 651- 982 -2499 <br />building@ci.lino-lakes.mn.us <br />