Helena Township Building Permit Application

Building Permit Application

Project Address:
Applicant Name:
Address:
City: State: Zip:

Day Phone: Evening Phone:
E-Mail:

Property Owner:
Name:
Address:
City: State: Zip:

Contractor Info:
Name:
Address:
City: State: Zip:

State Contractor’s License Number, if applicable:
Legal Description:
Parcel Number: Number of acres: Section:
Lot: Block: Subdivision Name:

The above applicant applies for a permit to:
Use:
Type of heating system:
Dimensions of structure:
Estimated cost or value:
Number of bedrooms:
Are wetlands affected? Yes No

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27466 Delmar Avenue, New Prague MN 56071 - Phone: 952-758-4505 - [Map] - the clerk
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