City of Edina Form Center

2. Instructions
   Please fill out this form to request a building permit escrow release. Fill out one form for each address being requested.
4. For a new construction permit, do not submit a request for escrow refund until as-built survey is approved, final inspection complete and certificate of occupancy is issued.
6. Permit Number*
7. Escrow Refund Amount*
9. Project Site Street Address*
11. As-built submitted to City?*

    1. Yes

    1. No
12. Final Certificate of Occupancy Issuance Date*
    Final Certificate of Occupancy Issuance Date
14. Contractor Company Name*
16. Contractor Mailing Address*
18. City*
19. State*
20. Zip Code*
22. Contact Name for Questions*
24. Contact Email*
25. Contact Phone*
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field