Fillable APPLICATION FOR AN ABOVE-GROUND POOL PERMIT (City of Jordan, MN)

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APPLICATION FOR AN ABOVE-GROUND POOL PERMIT (City of Jordan, MN)

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The APPLICATION FOR AN ABOVE-GROUND POOL PERMIT (City of Jordan, MN) form is 1 page long and contains:

  • 2 signatures
  • 9 check-boxes
  • 16 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Jordan, MN

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City of Jordan – Application for Pool Permit Last Updated 8/25/2020 Page 1
APPLICATION FOR AN ABOVE-GROUND POOL PERMIT
CITY OF JORDAN
210 EAST FIRST STREET
JORDAN, MN 55352
952-492-2535
Site Information
Site Address: _________________________________________________________________________________
Legal Description: _____________________________________________________________________________
Applicant / Contractor Information
Name: ______________________________________________ Phone: __________________________________
Address: ______________________________________________ Email: _________________________________
Owner Information ([ ] Check if same as above)
Name: ________________________________________________ Phone: ________________________________
Address: ______________________________________________ Email: _________________________________
Pool Information
All outdoor pools require a wall or surrounding fence of the non-climbing type that is at least 48-inches tall.
Pool Depth: ______ Fence Height: ______
Do fence openings have self-closing or self-latching devices? ___ Yes ___ No
Are the openings between the bottom of the fence and the ground under 3 inches or less? ___ Yes ___ No
Is the proposed pool outside of a 10 foot setback in all front, side, and rear yards? ___ Yes ___ No
Is the pool located a safe distance away from any above and underground utility lines? ___ Yes ___ No
A site plan illustrating the proposed location of the pool and fence on the property must be submitted with this
application.
I certify that I have read the City of Jordan Residential Swimming Pool Informational Handout and that all
information submitted is true and correct.
Applicant Signature: _______________________________________ Date: ______________________________
Owners’ Signature(s):_______________________________________ Date: ______________________________
________________________________________ Date: ______________________________
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City of Jordan – Application for Pool Permit Last Updated 8/25/2020 Page 2
FOR OFFICE USE ONLY
DATE SUBMITTED: _________ DATE COMPLETE: ___________ IF INCOMPLETE, DATE LETTER SENT TO APPLICANT: _______
FEE PAID: _________ DATE FEE PAID: ___________ FILE #_________
APPROVED _______ DENIED _______ BY___________________________________________________________________
DATE OF ACTION: ______________
DATE APPLICANT/PROPERTY OWNER NOTIFIED OF CITY STAFF ACTION: _________________
DATE POOL PERMIT ADDED TO PROPERTY ADDRESS FILE: __________________
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APPLICATION FOR AN ABOVE-GROUND POOL PERMIT (City of Jordan, MN)

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Completed 9 February 2021

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