Fillable BUILDING Permit Application SINGLE FAMILY & MULTI FAMILY (City of Elk River)

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BUILDING Permit Application SINGLE FAMILY & MULTI FAMILY (City of Elk River)

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The BUILDING Permit Application SINGLE FAMILY & MULTI FAMILY (City of Elk River) form is 2 pages long and contains:

  • 2 signatures
  • 17 check-boxes
  • 31 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Elk River

BROWSE CITY OF ELK RIVER (MN) FORMS

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Office Use Only
Notes: Scan
Permit Total:
$ _____________
BUILDING
SINGLE FAMILY & MULTI FAMILY DWELLING
Permit Application
City of Elk River
Building Safety Division
13065 Orono Parkway NW Elk River, MN 55330
763.635.1060 E-mail: Building@ElkRiverMN.gov
Site Address: __________________________________________________ PID #________________________________________
Subdivision _____________________________________________________________ Lot ________ Block ________
Property Type: Single Family Multi-family Twin home
Construction Type: New Addition Remodel Repair Alteration Other ____________
The Applicant Is: Owner Contractor Other ____________________
Property Owner:
Name ______________________________________________________ Phone ______________________________________
Address ____________________________________________ City _________________ State ________ Zip _____________
Email _______________________________________________________________
Contractor:
Business Name ______________________________________________ License/Bond _________________________________
Address ____________________________________________ City _________________ State ________ Zip _____________
Office Phone _________________________________ Cell _______________________________
Email _______________________________________________________________
Payment Options:
Call me for credit card payment (If different than above, please note: Phone: ______________________________________)
Send Check (Please make checks payable to the City of Elk River)
Pay in person via Credit Card, Check, or Cash
Receipt of Permit Options:
Email permit (If different than above, please note: Email : ______________________________________________________)
Pick up in person (All permits with plans needs to be picked up)
PLEASE COMPLETE OTHER SIDE OF APPLICATION
__________________________________________________________________________________________
Office Use Only Approved by: ______________ Date: ____________ Permit fee: _______ Plan check fee: _______ State surcharge fee: ___________
Sewer fee: __________ License fee: ___________ Construction type: _________ Occupancy group: _________ Division: ________ Total SQ FT of __________
Called or L/M Date: _____________ Int. ______ Last Modified 04/2018
Date: ______________________
Permit #:______________________
Detailed description of work:
* Please note: Separate permits are required for electrical, plumbing, and/or mechanical work.
Total Job Valuation $ _____________________
This is an application for a permit – It is not valid until processed
I hereby apply for a Building Permit, and I acknowledge that the information above is complete and accurate. I understand this is not a permit and work is
not to start without a permit.
I understand and hereby agree that the work for which the permit issued shall be performed according to; (1) the conditions of the permit; (2) the
approved plans and specifications; (3) the applicable city approvals, ordinances, and codes; and, (4) the state building/mechanical codes and regulations.
I understand that the permit will expire, and become null and void if work is not started within 180 days, or if work is suspended or abandoned for a
period of 180 days any time after work has commenced; and, that I am responsible for ensuring that all required inspections are requested in conformance
with the state building code.
____________________________________________________________________________________________________________
Signature of Contractor/Responsible Party Print Name Date
____________________________________________________________________________________________________________
Signature of Property Owner Print Name Date
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BUILDING Permit Application SINGLE FAMILY & MULTI FAMILY (City of Elk River)

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Completed 16 February 2021

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