Fillable APPLICATION RAZING PERMIT CITY OF OCONOMOWOC (City of Oconomowoc)

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APPLICATION RAZING PERMIT CITY OF OCONOMOWOC (City of Oconomowoc)

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BROWSE CITY OF OCONOMOWOC (WI) FORMS

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CITY OF OCONOMOWOC
APPLICATION
RAZING PERMIT
Date: Permit #: Tax Key:
Project Location:
Applicant Name: Phone #:
Applicant Address: City: Zip:
Contractor: Phone #:
Contractor Address: City: Zip:
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Before a permit can be issued to demolish or remove a building, the owner/applicant will complete and
submit all of the pre-permit information and must have the building inspector do a preliminary razing
inspection. (Information attached).
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SPECIAL PROVISIONS:
Excavation will be filled with a solid clean fill to match a lot grade within (5) five days of removal of structure.
Any excavation will be protected with appropriate fences, barriers, and erosion control measures. Asbestos,
underground tanks, and other health, safety, or environmental site conditions will be properly addressed by
the owner/applicant. Note: The owner/applicant will be responsible for the disposal of all material
pertaining to this RAZING PERMIT.
CONDITIONS OF APPROVAL:
The applicant agrees to comply with all information pertaining to this RAZING PERMIT.
Date:
Approval of Authorized Permit:
Signature of Applicant:
Permit Fee: Base fee of $100.00 per building + ( ________sq ft for all area x $.015) = $
Razing of a Building
Pre-Permit Information
-
Before a permit can be issued to demolish or remove a building, the owner/applicant will notify all utilities
having service connections to the building. The owner/applicant will have a representative from each utility
sign and date below, approving that their service connection has been removed, and/or plugged to their
satisfaction. After the appropriate utilities have signed off below, the Building Inspector must also do a
preliminary razing inspection. A City of Oconomowoc Building Inspector can be reached at (262) 569-2195.
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Sanitary Sewer Utility Representative – (262) 569-2192
Signature: Date:
Water Utility Representative – (262) 569-3199
Signature: Date:
Electric Utility Representative – (262) 569-2196
Signature: Date:
Storm Sewer Utility Representative – (262) 569-2191
Signature: Date:
Gas Utility Representative – (1-800-236-9874)
Signature: Date:
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Date when demolition is to commence: Date when demolition is to be complete:
A description of the method of demolition to be used:
A detailed description of how and where the waste materials resulting from the demolition will be transported
and disposed of, including a description of the route to be used by trucks in hauling of the waste materials:
NOTE: A list of all hazardous waste and hazardous and toxic substances (as defined by Sec. NR 181.12 and NR 158.03 (4), Wis.
Admn. Code as amended from time to time) contained in the building, a statement as to whether the building contains asbestos (as
defined by Sec. 140.04 (1)(a), Wisc. Stats.), and a detailed list of any hazardous waste, hazardous and toxic substances, and
asbestos. Owner/applicant will use current methods to prevent water runoff and soil erosion from the site to neighboring
properties and to prevent releasing unreasonable amount of dust from the site.
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APPLICATION RAZING PERMIT CITY OF OCONOMOWOC (City of Oconomowoc)

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Completed 4 August 2020

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