Application For Demolition Permit
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1APPLICATION FOR DEMOLITION PERMIT
PROPERTY INFORMATION
Property Address: _______________________________________________________
Zoning District: ________ Ward: _______
Owners Name:________________________________________________________
Parcel ID: ________ - _____ - ________
Address: ______________________________________________________________
Phone: (
) _______________
City: ______________________________State:______ Zip Code: _____________
Fax:
(
) _______________
STRUCTURE DESCRIPTION (All items below must be removed from lot)
Main Structure
Stories: __________
Type of Construction: _______________________
Type of Foundation: _________________________
Accessory Structures (Detached garages, sheds, etc.)
Stories: __________
Type of Construction: _______________________
Type of Foundation: _________________________
Retaining Walls
Height: __________
Type of Construction: _______________________
Fences
Height: __________
Type of Construction: _______________________
ESTIMATED COST OF DEMOLITION: $ _____________________
TOWNSHIP REGULATIONS
1.
As a condition for the issuance of a demolition permit, the owner or the owners agent shall give written notice to the
owners of adjoining properties and to the owners of any property who utility services must be temporarily shut, removed or
affected because of the proposed demolition work
2.
Before a structure is demolished or removed, the owner or agent shall notify all utilities having service connections within
the structure such as water, electric, gas, sewer and other connections. A permit to demolish or remove a structure
shall not be issued until a release is obtained from the utilities, stating that their respective service connections and
appurtenant equipment, such as meters and regulators, have been removed or sealed and plugged in a safe manner.
3.
Whenever a structure is demolished or removed, the premises shall be maintained free from all unsafe or hazardous
conditions by the proper regulation of the lot, restoration of established grades and the erection of the necessary retaining
walls and fences in accordance with the provisions of Chapter 33 of the 2009 International Building Code.
APPLICANT INFORMATION
□
□
□
□
I certify that I am the
Owner
Contractor
Agent
Other- _________________________
Name: ____________________________________________________________________________________________________
Address: ______________________________________________________________ City: ______________________________
State:______ Zip Code: _____________
Phone:
(
) _______________
Fax:
(
) _______________
I the undersigned owner or authorized agent for the above referenced property, certify that all statements and data furnished with this
application are true and correct; I also am aware and will complete the demolition to the Township regulations and specifications.
________________________________________________________
_____________________
Signature of applicant
Date
BOROUGH USE ONLY
$ _______
Permit No. _____________
DEMO FEE:
$ _______
Invoice No. _____________
SCAN FEE:
$ _______
Check No. _____________
DOC. FEE:
□
□
$ ___4.00
Utility clearances attached with permit?
Yes
No
PA UCC FEE:
□
□
$ _______
Copy of letters to adjoining property owners attached?
Yes
No
TOTAL FEE:
Permit approved: __________________________________________________
Date: ______________
Homestead Building Code Official
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