Fillable CITY OF JORDAN 210 EAST FIRST STREET JORDAN, (City of Jordan, MN)

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CITY OF JORDAN 210 EAST FIRST STREET JORDAN, (City of Jordan, MN)

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City of Jordan – Application for Chicken Permit Last Updated 8/27/2020 Page 1
APPLICATION FOR CHICKEN PERMIT
CITY OF JORDAN
210 EAST FIRST STREET
JORDAN, MN 55352
952-492-2535
Applicant Information
Name: ______________________________________________ Phone: __________________________________
Address: ______________________________________________ Email: _________________________________
Owner Information ([ ] Check if same as above)
Name: ________________________________________________ Phone: ________________________________
Address: ______________________________________________ Email: _________________________________
Number of Chickens:
Leg Band Numbers: Breed:
1.
2.
3.
4.
5.
6.
I agree to the Ordinance 2015-08 and to comply with the City of Jordan City Code regarding Chickens
I will maintain a sanitary and healthy environment for the chickens that I keep.
My chicken coop and run are placed on my property at least 25 feet away from my side and rear property
lines and outside of any easements.
I will not sell any chickens or chicken by products on my property.
Applicant Signature: ______________________________________ Date: _____________________
Owners’ Signature(s):_______________________________________ Date: _____________________
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City of Jordan – Application for Chicken Permit Last Updated 8/27/2020 Page 2
A flat fee of $20.00 is due upon issuance of this permit. The applicant will be responsible for keeping a copy of the
permit on site. The City will maintain records and homeowners should do the same. This permit must be renewed
every year by paying the annual fee of $20.00. This permit will expire on December 31
st
of each year.
Record of Renewal: (provide applicant with copy each time renewal occurs)
Date:____________________ Fee Paid Date:____________________ Fee Paid
Date:____________________ Fee Paid Date:____________________ Fee Paid
Date:____________________ Fee Paid Date:____________________ Fee Paid
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CITY OF JORDAN 210 EAST FIRST STREET JORDAN, (City of Jordan, MN)

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Completed 9 February 2021

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