CITY OF FORT CALHOUN
POOL/FENCE PERMIT APPLICATION

Application for: ______________________________________________________Date: ________________

Property Owner: ______________________________________________ Phone: _____________________

Property Address: __________________________________________________________________________

Legal:   Lot(s) : _____________________ Block: ___________ Addition: ______________ Zone: ________

Contractor: ________________________________________________________________________________

Address: _____________________________________________________ Phone: ______________________

Description of Work: ________________________________________________________________________

___________________________________________________________________________________________

Cost of Project: _______________________________          Plot Plan Received:        yes                   no

Setbacks:  Front: ___________ Rear: ____________ Interior Side: __________ Street Side: ___________
(Setbacks are determined from PROPERTY LINES)

Applicant’s Signature_______________________________________________________________________                  

___________________________________________________________________________________________

DO NOT WRITE BELOW THIS LINE – FOR OFFICE USE ONLY

_____________________________________                                  ________________________________
P. C. Designee Signature                                                                       P. C. Designee Signature

INSPECTIONS REQUIRED:

                        FENCE – SETBACK, HEIGHT, GATE