Fillable APPLICATION FOR TOWERS, ANTENNA AND/OR SATELLITE DISHES (City of Jordan, MN)

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APPLICATION FOR TOWERS, ANTENNA AND/OR SATELLITE DISHES (City of Jordan, MN)

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The APPLICATION FOR TOWERS, ANTENNA AND/OR SATELLITE DISHES (City of Jordan, MN) form is 2 pages long and contains:

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  • 3 check-boxes
  • 24 other fields

Country of origin: US
File type: PDF

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

BROWSE CITY OF JORDAN, MN (MN) FORMS

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City of Jordan – Application for Towers and Antennas Last Updated 8/25/2020 Page 1
APPLICATION FOR TOWERS, ANTENNA AND/OR SATELLITE DISHES
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: _________________________________
I/We, the undersigned, hereby make the following application to the City Council and Planning Commission of the City of Jordan, Scott County,
Minnesota. (Applicants have the responsibility of checking all applicable ordinances pertaining to their application and complying with all
ordinance requirements):
1. Proposed height of tower:
_____________________________________ If over 200’ FAA must be contacted.
2. Proposed location of tower: ________
front yard ________ side yard ________ rear yard
3. Proposed setbacks from property lines: ________
front yard ________ side yard ________ rear yard
(Note: Not permitted within the required front yard, nor within 12’ of side or rear lot lines).
4. Type of structure proposed (e.g. amateur radio tower, dish, etc.): ______________________________
_____________________________________________________________________________________
5. Zoning District in which the proposed structure will be located: ________________________________
6. Are you proposed to light the tower? ____ Yes ____ No If yes, describe lighting proposed.
_____________________________________________________________________________________
7. Distance from the closest existing tower: ___________________________________________________
8. Attach a copy of a site plan illustrating the proposed location and height of the structure, with setbacks
clearly identified.
9. A deposit is required of $5000 into an escrow account to ensure no damages occur to city property.
City of Jordan – Application for Towers and Antennas 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 PERMIT ADDED TO PROPERTY ADDRESS FILE.
I certify that all information submitted is true and correct.
Applicant Signature: ______________________________________ Date: ________________________
Owners’ Signature(s): _______________________________________ Date: ________________________
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APPLICATION FOR TOWERS, ANTENNA ANDOR SATELLITE DISHES (City of Jordan, MN)

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Completed 9 February 2021

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