City Forms
& Permits

Forms:

1. APPLICATION FOR ZONING PERMIT
2. APPLICATION AND PERMIT FOR
SEWER AND WATER SERVICE
3. CITIZEN COMPLAINT/REQUEST FORM
   

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BUILDING PERMIT APPLICATION
CITIZEN CONPLAINT FORM
PRINCETON IS GOING GREEN
PERMIT RECEIPT FOR WATER & SEWER CONNECTION
SIDEWALK PERMIT
TEMPORARY CANCELATION OF SERVICES
UTILITY “EASY-PAY”
UTILITY APPLICATION
GOLF CART REGISTRATION
RECORDS_REQUEST_FORM
VACATION WATCH/EXTRA PATROL

BUILDING PERMIT APPLICATION

 

BUILDING PERMIT APPLICATION

311 THIRD STREET P O BOX 307 PRINCETON IA 52768 PHONE 563-289-5315 FAX 563-289-5862

PROJECT STREET ADDRESS______________________________________________________________________DATE__________________

OWNER CONTRACTOR

NAME __________________________________________________ NAME__________________________________________________

ADDRESS_______________________________________________ ADDRESS______________________________________________

CITY/STATE/ZIP__________________________________________ CITY/STATE/ZIP_________________________________________

CONTACT NUMBER______________________________________ CONTACT REGISTRATION NUMBER____________________

USE/OCCUPANCY ___________________________________ PROJECT DESCRIPTION ESTIMATED TOTAL COST

_____________________________________________________________________________________ $ ___________________________

_____________________________________________________________________________________ 1 Family Other Residential 2 Family Commercial/Other

TYPE OF PROJECT New Structure Addition Remodel Demolition/Moving Building Swimming Pool (sketch plan may be required) Roof Sign Siding Fence Excavation/Fill Handicap Ramps Deck Dock Accessory Building Antenna/Tower

NEW CONSTRUCTION Residential or Commercial Building Type: SQFT of structure ______________________________________________

Is this an accessory building or garage? Yes No if yes, list dimensions: _______________Ft. X ______________Ft. Construction Type ______________________________________________ Fire-extinguishing system being installed? Yes No If yes, please list value: $____________ # of heads/valves ______

ADDITION/REMODEL PERMIT Residential or Commercial Type:

FOR OFFICE USE ONLY

PERMIT NUMBER PERMIT FEE $

Type of Remodel: Windows Kitchen Bathroom Basement Finishing Attic Conversion Other____________________________ Type of Addition: Deck or Porch Room Addition Carport Concrete Other ______________________________________ Fire-extinguishing system being installed? Yes No If yes, please list value: $____________ # of heads/valves ______ ROOFING/SIDING PROJECTS Tear Off? Yes No SIGN PERMIT Type of Sign: _____________ Type of material being used?:____________________________ Will Sign be Powered?: Yes No # of Layers when finished:______ # of Squares: _________ Dimensions: ________ X __________ ANTENNA/TOWER Dimensions ________________________ DEMOLITION OR MOVE BUILDING PERMIT SWIMMING POOL Dimensions or Radius: ________ Type of structure: __________________ # of Stories __________ # of Gallons: _______ Depth: _______ SqFt of structure: _____________________________________ Pool is: In ground Above Ground Heated Utility Cuts: Sewer: ___ / ___ / ________ Gas: ______ / ______ / ________ Barrier required: ______ Fence ______ Locking ladder Electric: ______ / ______ / ________ Water: ______ / ______ / ________ other _____________ FENCE Height _____________ Type of Material _____________ DOCKS _____ Personal Use Only/Must Meet Flood Plain Solid (privacy) or open type _________________________________ Requirements**

**Flood Plains Require a Separate Permit 1. Survey Certificate (standard form) containing legal description.

2. Building plans and schematics for mechanical systems shall be submitted in triplicate (3) for commercial and industrial and in duplicate (2) for residential. An Iowa’s architect of engineer’s seal is generally required, as specified by the Building Inspector. Separa te plans are required for sprinkler systems and alarm systems and shall be submitted in duplicate (2) and shall be stamped for approval by a fire department official.

3. Site/Plot plans shall be submitted in quadruplicate (4), illustrating site utilites including landscape plans, paving and parking plans; curb cuts’ sewer, water and gas line locations, storm water and finish grade.

4. Septic systems require prior approval from the Scott County Health Department for soil percolation tests. 5. Food establishments and public bath facilities require prior approval from the Scott County Health Department. 6. Soil erosion plans and flood plain verifications.

IF SITE/SKETCH PLAN IS REQUIRED, IT MUST ACCOMPANY APPLICATION TO OBTAIN PERMIT.

The undersigned "PERMITTEE" OR "AUTHORIZED AGENT" hereby acknowledges and agrees to the following terms:

1. All work performed under this permit shall be performed in strict compliance with any and all applicable Federal, State, County, and local laws. 2. This permit DOES NOT authorize the use of any portion of any public right-of-way or public property, for any purpose, unless otherwise specifically stated herein. 3. The authorizations, permission, and grants of certain rights associated with the issuance of this permit expire within twelve (12) months from the date of issuance as shown herein OR within one hundred and eighty (180) days from said date if the "start of construction" has not occurred within that time frame. 4. Any and all work authorized and approved under this permit shall be performed in accordance with the approved plans, detailed specifications, and/or special conditions and provisions as stated herein or as attached as a part of this permit and shall not be changed, modified, or altered in any way without the prior authorization and written acknowledgement of the City. 5. HOURS FOR CONSTRUCTION WORK: It shall be unlawful for any person to engage in or to conduct any "construction activity" anywhere in the City between the hours of 10:00pm and 7:00am on Monday through Saturday, before 7:00am Monday, and at any time on Sunday, when the "noise disturbance" emanating from any such activity exceeds those decibel levels as established in Chapter 48 of the Code of Ordinances of the City of Princeton. 6. FAILURE TO COMPLY WITH ALL OF THE TERMS AND CONDITIONS ASSOCIATED WITH THE ISSUANCE OF THIS PERMIT IS A MUNICIPAL INFRACTION PURSUANT TO CHAPTER 4 OF THE CODE OF ORDINANCES OF THE CITY OF PRINCETON, AND MAY RESULT IN A CITATION, $750 FINE, OR BOTH.

PERMITTEE'S ACHNOWLEDGEMENT AND REPRESENTATIONS THE UNDERSIGNED PERMITTEE HEREBY ACKNOWLEDGES AND REPRESENTS THAT THE INFORMATION SUBMITTED HEREIN AND ATTACHED AS A PART OF THIS APPLICATION FOR CONSIDERATION BEFORE THE PLANNING AND ZONING COMMISSION OF THE CITY OF PRINCETON IS COMPLETE, TRUE AND ACCURATE IN ALL REGARDS, FURTHER, THE PERMITTEE ACKNOWLEDGES AND UNDERSTANDS THAT THE FILING OF THIS APPLICATION DOES NOT GUARANTEE ANY SPECIFIC, DESIRED RESULT OR ACTION, BUT MERELY PROVIDES AN ADMINISTRATIVE REVIEW AND CONSIDERATION PROCESS FOR THE SUBJECT MATTER AS ALLOWED BY LAW. PRINTED NAME OF PERMITTEE OR AUTHORIZED AGENT DATE OF SUBMITTAL SIGNATURE OF PERMITTEE OR AUTHORIZED AGENT

ALL WORK MUST CONFORM TO THE CODES OF THE CITY OF PRINCETON

I hereby certify that I have the authority to make the foregoing application, that the information given is correct, and that all construction will comply with the applicable ordinances of the City of Princeton and the State of Iowa.

Printed Name of Owner/Contractor: ___________________________________________ DATE: ___________________

Signature of Owner/Contractor: ________________________________________________________________________

FOR OFFICE USE ONLY

APPROVAL ZONING ADMINISTRATOR: ________________________________________ DATE: ________________ APPROVAL BUILDING INSPECTOR: ____________________________________________ DATE: __________


CITY OF PRINCETON

311 Third Street ~ P.O. Box 307
Princeton, Iowa  52768
Phone (563) 289-5315 ~ Fax (563) 289-5862

 

Citizen Complaint Form

 Please complete the following information so that the City can investigate your complaint.  Please print clearly.

 Date                                                               

 Name                                                                                                                                      

 Address                                                           Phone Number                                               

 Nature of Complaint:  (include the date, time, place, and facts of your complaint)

                                                                                                                                                

                                                                                                                                                

                                                                                                                                                

                                                                                                                                                

 Explain how you feel the complaint should be resolved:

                                                                                                                                               

                                                                                                                                               


 Signature _____________________________________         Date                                                

All complaints must be signed and dated to be considered valid.

 Received in City Hall by:  ________________________________ Date: ______________________________

City Hall Office Use Only:

Received by:______________________________________  Date _________________

Mayor’s Signature:________________________________   Date_________________

Comments:_____________________________________________________________________________

______________________________________________________________________________________
Copied to:

Council                                                                                  Chair of Water/Sewer

Chair of Home & Community Environment                             Chair of Policy & Admin

Chair of Community Protection                                              Chair of Buildings


CITY OF PRINCETON

PERMIT RECEIPT FOR

WATER AND SEWER CONNECTION

 


Sewer Connection of $___________  Paid by         Check #________      Cash________


Water Connection of $___________  Paid by        Check#________       Cash________

Property Location ____________________________________________________________

I hereby certify that the above fees are satisfied and applicable materials may be released to:

 ____________________________________________________________________________
Contractor/Plumber

Signed and released on this ____ day of ___________, 20____by:

____________________________________   or  ____________________________________
AJ Grunder, City Clerk/Treasurer                                                 Patty Morgan, Deputy Clerk

 

DATE STAMP HERE                       POST STAMP HERE                       ATTACH METER NUMBERS HERE

  

________________                ________________                ____________________________

 

I hereby certify that the Public Works Department has released all applicable materials to the above listed representative on this ____ day of ____________, 20___.

 ____________________________________________
Public Work Official


 IS GOING GREEN!!

 

To participate in this program, please fill out the bottom of this page and return it to City Hall.  Don’t forget to check out our new EASY-PAY program for ACH payments on City of Princeton Utility Accounts.

 

 

I do hereby agree to have my Utility Statement sent to my address via e-mail.  It will be my responsibility to furnish, to the City Clerk, a current e-mail address and to notify the City Clerk of any changes in delivery of said Utility Statement whether electronic or standard mail.  The City of Princeton will not knowingly share any e-mail address without the expressed permission of the account holder.

 

Customer Account Number ____________________________

Customer Name _____________________________________

Customer Address ___________________________________

 

E-Mail Address _____________________________________

                                       (Please print carefully and clearly)

 

Signature_____________________________ Date __________



CITY OF PRINCETON

SIDEWALK PERMIT

 

136.08    PERMIT REQUIRED.  No person shall remove, reconstruct or install a sidewalk unless such person has obtained a permit from the City and has agreed in writing that said removal, reconstruction or installation will comply with all ordinances and requirements of the City for such work.

 

DATE:________________               LOCATION: _____________________________________________

 

TYPE OF WORK:     ___REMOVAL         ___RECONSTRUCTION     ___INSTALLATION

 

EXCEPTIONS:__________________________________________________________________________

 

APPROVED BY ________________________________  DATE APPROVED ______________________

 

FINAL INPECTION APPROVAL__________________________ DATE APPROVED______________

 

BY MY SIGNATURE BELOW, I CERTIFY THAT I WILL COMPLY WITH THE SIDEWALK STANDARDS OF THE CITY OF PRINCETON AS STATED BY ORDINANCE IN CHAPTER 136.09 & 136.10:

136.09    SIDEWALK STANDARDS.  Sidewalks repaired, replaced or constructed under the provisions of this chapter shall be of the following construction and meet the following standards:

1.                  Cement.  Portland cement shall be the only cement used in the construction and repair of sidewalks. 

2.                  Construction.  Sidewalks shall be of one-course construction, subject to the provisions of Section 136.09(2a). Sidewalks must also have reinforcement within the cement. Types of reinforcement shall be in the form of rebar, remesh, fiberglass, or other such reinforcement material, with such determination of the extent of reinforcement to be reviewed and approved by the Council or its duly authorized agent.

 

A.             If one-course construction is not possible, concrete terminations shall be bonded by one half inch (1/2) rebar drilled or poured in place at least one (1) times thickness for depth of drilled pocket and pinned into the established hard concrete protruding into the “new” pour at least two (2) times the thickness to allow adequate bonding and to minimize shifting of the joint.

3.                  Sidewalk Base.  Concrete may be placed directly on compact and well-drained soil.  Where soil is not well drained, a three (3) inch sub-base of compact, clean, coarse gravel or sand shall be laid.  The adequacy of the soil drainage is to be determined by the City.  

4.                  Sidewalk Bed.  The sidewalk bed shall be so graded that the constructed sidewalk will be at established grade.

5.                  Length, Width and Depth.  Length, width and depth requirements are as follows:

A.                 Residential sidewalks shall be at least four (4) feet wide and four (4) inches thick, and each section shall be no more than four (4) feet in length.

B.                 All sidewalks throughout the Business District shall be constructed from lot line to the curb line unless the location of the sidewalk is varied by an appropriate resolution of the Council upon application by the landowner.

C.                 Driveway areas shall be not less than six (6) inches in thickness.
 

6.                  Location.  Residential sidewalks shall be located with the inner edge (edge nearest the abutting private property) on the property line, unless the Council establishes a different distance due to special circumstances.

7.                  Grade.  Curb tops shall be on level with the centerline of the street which shall be the established grade.

8.                  Elevations.  The street edge of a sidewalk shall be at an elevation even with the curb at the curb or not less than one-half (½) inch above the curb for each foot between the curb and the sidewalk.   

9.                  Slope.  All sidewalks shall slope maximum one-quarter (¼), minimum one eighth (1/8) inch per foot toward the curb.

10.                Finish.  All sidewalks shall be finished with a “broom” or “wood float” finish.  

 

136.10          INSPECTION.

The Council or its duly authorized agent shall have full power to inspect the construction, repair and maintenance of all sidewalks and shall have the authority to authorize and approve exceptions to the Sidewalk Standards in Section 136.09 and to cause the issuance of a Permit in accordance with Section 136.08, with any said exceptions.  The authority of the Council or its duly authorized agent shall not be questioned by any person, firm or corporation constructing or repairing the sidewalk.   

_____________________________________________________              _________________________

PROPERTY OWNER SIGNATURE                                                               DATE



CITY OF PRINCETON

TEMPORARY CANCELATION OF SERVICES

 


DATE:__________

NAME:_______________________________________________________

LOCATION:_____________________________   ACCOUNT:___________

DATE OF VACANCY:______________  DATE OF RETURN:____________
(must be more than 1 mo., yet less than 6 months to qualify)

FOWARDING ADDRESS:________________________________________

ADMINISTRATIVE FEE, $10.00 – not applicable for garbage stop only

GARBAGE STOP ONLY:  Customer Signature________________________


For City Hall Use Only

 CHECK #_______   DATE OF PAYMENT:_________  POSTED:_________

 SERVICES STOPPED IN COMP:_______  SERVICES RESTORED:______

 

NOTICE:  You will receive a complete utility bill the month after vacating, months to follow until your return will consist of Capital Improvement Charges only.  During a period when service is temporarily cancelled as provided in Ord. 92.09, there shall be no minimum service charge.  IF THERE IS ANY USAGE DURING THE TEMPORARY CANCELLATION, THE PROPERTY OWNER WILL BE BILLED THE USAGE IMMEDIETLY DURING THE NEXT BILLING CYCLE.  This temporary cancellation does not in any way exclude the property owner from being charged the Capital Improvement fee.

 I have read the above notice and agree to all terms and conditions.

 Owner Signature:___________________________    Date:___________________

    City Clerk/Deputy Clerk Signature:____________________________

             NOTES:_______________________________________________



Princeton Logo      Princeton Logo      Princeton Logo

CITY OF PRINCETON

UTILITY “EASY-PAY”

 THE CONVENIENT, EASY WAY TO PAY YOUR MONHTLY WATER BILL!

 

WHAT IS EASY-PAY?

With our EASY-PAY service, payment of your monthly water/sewer/garbage bill is automatic, so you save time, effort and postage.  Plus, electronic banking makes EASY-PAY accurate and reliable.

EASY-PAY BENEFITS FOR YOU

                                 ***     Convenient and Easy      ***     Time Saving     ***     Accurate and Reliable     ***

HOW DOES EASY-PAY WORK?

You will continue to receive your monthly bill noting your account is ACH.  You will know how much your bill will be and how much the financial institution will automatically deduct from your checking or savings account.  This amount will be deducted the 15th day of each month.

HOW DO I SIGN UP?

It is easy to sign up for EASY-PAY!  Just complete the authorization form and mail or bring to City Hall.

Should you have questions, please call AJ or Patty @ 563-289-5315.  Thank You!

EASY-PAY AUTHORIZATION FORM

_________________________________                                        ________________________________

PRINCETON UTILITY ACCOUNT NUMBER                                                               FINANCIAL INSTITUTION   

_________________________________                                        ________________________________

NAME                                                                                                                   FINANCIAL ROUTING NUMBER

_________________________________                                        ________________________________

ADDRESS                                                                                                             ADDRESS                             CITY

_________________________________                                        ________________________________

CITY                       STATE                    ZIP                                                          CHECKING ACCOUNT NUMBER

_________________________________                                        ________________________________

SIGNATURE                                                                                                        SAVINGS ACCOUNT NUMBER

 

I authorize the City of Princeton and the financial institution so named to initiate variable entries to my checking/savings account.  I acknowledge that the origination of each ACH transaction to my account must comply with the provisions of U.S. Law and all NACHA rules and regulations. This authority will remain in effect until I notify the City of Princeton and the financial institution in writing to cancel in time as to afford the financial institution reasonable opportunity to act.

 

Also, I agree that I remain obligated to pay for utility services in the event that a charge to my account is dishonored, for whatever reason, and the City of Princeton retains its normal collection rights.

 

Complete this form and return to City Hall with a voided check.

Mail Form To:       City of Princeton    311 3rd Street, P.O. Box 307, Princeton, Iowa  52768




 

311 THIRD STREET
P. O. BOX 307
PRINCETON  IA  52768
Phone 563-289-5315—Fax 563-289-5862
E-Mail  Cityofprinceton@iowatelecom.net
Web-site- princetoniowa.us

UTILITY APPLICATION

Name:______________________________SS#_______________________

Service Address________________________________________________

Mailing Address________________________________________________

Home Phone______________________Driver’s License_______________

Employer_________________________Phone_______________________

Spouse_____________________________SS#_______________________

Emergency Contact___________________Phone #___________________

Check which applies
Homeowner   ____    Rent_____Landlord Name______________________

Date of Occupancy____________________

***May we share your name and address only with the
Welcome Committee?***   Yes___     No___

 Deposit_____________CK #_____________Cash___________

 
Customer Signature_______________________________Date__________

 Water Reading_______________Date___________

 Shut off Reading______________Date__________


 

City of Princeton Golf Cart Registration

 

                 Princeton Permit # ______________                    Issue Date______________

Make:__________________  Model:___________________  Serial #: _____________________

 Name: _________________________________________________________________________ 

Address: ________________________________________________________________________

P.O. Box:________________________________________________________________________

Phone: Home_________________________                 Cell________________________________

Attach Driver’s License Copy to Application:  YES   NO

Attach Proof of Liability Insurance to Application:  YES  NO

I understand this permit is issued to me and will apply solely to my golf cart. I understand drivers of the golf cart other than myself must be at least 18 years of age and possess a valid Iowa driver’s license.  I understand that as the permit holder, I will be held responsible for any violations or penalties. 

I have received a copy of Ordinance #316, Chapter 74 of the Code of Ordinances of the City of Princeton. 

Applicant’s Signature: ______________________________________

Applicant’s Printed Name: __________________________________

Approved by: ___________________________________

Police Chief, City of Princeton


RECORDS REQUEST FORM  

Records Request



Police Department

311 Third Street  Box 307  Princeton, IA 52768

Chief Brian L Carsten

Office (563) 289-3454      princetonpolice@iowatelecom.net          Fax (563) 289-5460

Vacation Watch/Extra Patrol

 

________________________________                        ___________________________________

(Address to be watched)                                                                                    (Reason for watch)

 

________________________________                        ________________                        ________________

(Residence name)                                                                                                          (Phone#)                                                           (Phone #)

 

________________________________________________                                ________________                        ________________

(e-mail)                                                                                                                                     (Phone #)                                                          (Phone #)

 

 Departure Date       ____/____/____                                           Return Date ____/____/____

 

Alarm System ( ) Yes ( ) No           ___________________________           ________________

                                                                                                            (Alarm Company)                                                                                  (Phone #)

 

Lights Left on ( ) Yes ( ) No           _____________________________________________

                                                                                                                                                (Location)

 

Authorized people on property/Emergency Contacts                                                                     House Keys

 

1)         ____________________________________               _____________                   ( ) Yes ( ) No

            (Name)                                                                                                                                                              (Phone #)                                                         

 

2)         ____________________________________               _____________                   ( ) Yes ( ) No            (Name)                                                                                                                                                              (Phone #)

 

3)         ____________________________________               _____________                   ( ) Yes ( ) No

            (Name)                                                                                                                                                              (Phone #)

 

4)         ____________________________________               _____________                   ( ) Yes ( ) No

            (Name)                                                                                                                                                              (Phone #)

 

Vehicles on property                                                                                                         Animals on property            ( ) Yes ( ) No

 

_______        _______        ___________           ________                  ___________            ________________

(color)               (make)              (model)                                     (plate #)                        (Animal type)                 (Location)

 

_______        _______        ____________         ________                  ___________            ________________

(color)               (make)              (model)                                     (plate #)                        (Animal type)                 (Location)

 

_______        _______        ____________         ________                  ___________            ________________

(color)               (make)              (model)                                     (plate #)                        (Animal type)                 (Location)

 

 

I will notify the Princeton Police Department IMMEDIATELY upon my return, or when the residence becomes occupied.

 

Signature: _________________________________  Date of Request  ____/____/____


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