REMEMBER CALL BLUE STAKES BEFORE YOU DIG 1-800-662-4111
Date of Application:
Date Work Starts:
Dated Issued:
Permit Number:
Property Address:
Valuation of Fence: (cost)
Owner of Property:
Phone Number:
Mailing Address:
City-Zip Code:
Contractor:
Phone Number:
Contractors Business Address:
State License Number:
Email: (required for inspection results)
Other
REMEMBER CALL BLUE STAKES BEFORE YOU DIG
This permit, once issued, becomes null and void if work or construction authorized is not commenced within 180 days, (6 months) or if construction or work is suspended or abandoned for a period of 180 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction and I make this statement under penalty or perjury.
Signature of Contractor; Owner; or Authorized Agent: ____________________________________________________
1-800-662-4111
Date: ________________
This application does not become a permit until signed below Office Use Only:
Signature of Approval:
Date:
_________________________________________________________ Please call 435-734-6604 for inspection once fence is completed
Corner Lot
Interior Lot
Fence Type:________________ Fence Height: ______________
Comments: ________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________
Date Work Starts:
Dated Issued:
Permit Number:
Property Address:
Valuation of Fence: (cost)
Owner of Property:
Phone Number:
Mailing Address:
City-Zip Code:
Contractor:
Phone Number:
Contractors Business Address:
State License Number:
Email: (required for inspection results)
Other
REMEMBER CALL BLUE STAKES BEFORE YOU DIG
This permit, once issued, becomes null and void if work or construction authorized is not commenced within 180 days, (6 months) or if construction or work is suspended or abandoned for a period of 180 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction and I make this statement under penalty or perjury.
Signature of Contractor; Owner; or Authorized Agent: ____________________________________________________
1-800-662-4111
Date: ________________
This application does not become a permit until signed below Office Use Only:
Signature of Approval:
Date:
_________________________________________________________ Please call 435-734-6604 for inspection once fence is completed
Corner Lot
Interior Lot
Fence Type:________________ Fence Height: ______________
Comments: ________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________
