Demolition Permit Application - City Of Auburn

Demolition Permit Application - City Of Auburn - 2015 Page 2

OTHER

Have you contacted Puget Sound Clean Air Agency regarding asbestos abatement?  Yes

 No

(Please attach pertinent documentation)

Besides septic tanks, do you anticipate removing or decommissioning any other underground tanks?  Yes

 No

If yes, Type of tank: _______________________ Size (in gallons): ____________________ Removal or Decommission (circle one)

Have you discussed the tank removal or decommissioning with Valley Regional Fire Authority?  Yes

 No

 N/A

Have you discussed the tank removal or decommissioning with the State Department of Ecology?  Yes

 No

 N/A

Have you discussed Haul Route requirements with Public Works?  Yes

 No

 Owner

 Owner’s Agent

 Contractor

 Contractor’s Agent

APPLICANT (check one)

I certify that I have read this application and declare under penalty of perjury that the information contained herein is correct and complete. I

agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of

this city to enter upon the above mentioned property for inspection purposes. I am either the owner of the property on this permit application,

the Washington State registered contractor for the work, or I represent the owner or contractor as signified above and am acting with the

owner’s/contractor’s full knowledge or consent.

SIGNATURE

PRINT NAME

DATE

Demolition Permit Application - City Of Auburn - 2015 Page 2