Fillable BuildingMovePermit Customer Satisfaction Survey

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BuildingMovePermit Customer Satisfaction Survey

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The BuildingMovePermit Customer Satisfaction Survey form is 3 pages long and contains:

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File type: PDF

U.S.A. forms for City of Galva

BROWSE CITY OF GALVA (IL) FORMS

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Date:
Permit Number:
Fee Received:
Name:
Address:
City/State/Zip:
Phone:
Fax:
E-Mail Address:
PIN*:
Address:
City/State/Zip:
Age of Structure:
Name:
Company:
Address:
City/State/Zip:
Phone:
Fax:
E-Mail Address:
Dimensions**:
Square Footage:
Number of Stories:
Assessed Value:
City of Galva
311 N. W. 4th Avenue
Galva, IL 61434
Phone: (309) 932-2555
Fax: (309) 932-3306
www.galvail.gov
Building/Structure
Moving Permit
Application
Page 1 of 3
Applicant Moving Contractor
Donor Property (Where building or structure is currently located)
*PIN means Property Identification Number **Dimensions means Length x Width x Height of the structure (e.g., 60' x 40' x 22'6")
NOTE: If the building or structure is located outside the corporate limits of the City of Galva, a written, signed statement by a building
inspector or engineering firm indicating that the building or structure is in compliance with the City of Galva's building code must be
attached to this application. Any deficiencies noted by the inspector must be corrected prior to relocation or an irrevocable letter of
credit in an amount approved by the City of Galva to cover the estimated cost of all necessary improvements must be delivered to
the City Clerk's office before a permit will be issued.
Attach photographs of all sides (elevations) of the building or structure to be moved.
Will the building
or structure
require
remodeling? If
yes, please
describe:
Address or PIN of RECIPIENT PROPERTY (Where the building or structure is being moved):
Estimated Cost to Complete the Project (include plumbing, heating, electrical,
foundation, and landscaping costs rounded to the nearest dollar:
Submit a scaled site plan for the Recipient Property identifying the following:
ROUTE NOTIFICATION: The applicant is responsible for contacting the parties identified below and for providing them with the
planned travel route as well as the date of the move. Documentation related to the agreed upon travel route and any conditions for
compliance by the below named shall be provided to the Superintendent of Streets.
UTITLITY SERVICE DISCONNECTION (if within the corporate limits of the City of Galva): The applicant is responsible for contacting the
parties identified below to schedule the removal and/or disconnection of services prior to moving the building or structure. A permit
will not be issued until the City has verified that services have been disconnected and meters have been removed.
Page 2 of 3
Gas Meter Number:
Provider Name & Phone Number:
Representative's Signature or Contact Name:
Representative's Signature or Contact Name:
Provider Name & Phone Number:
Date of Disconnection & Removal:
Representative's Signature or Contact Name:
Water meter(s) removed, service excavated to main & turned off, "b" box removed & returned:
Representative's Signature or Contact Name:
Date of Disconnection & Removal:
Date of Disconnection & Removal:
Date of Disconnection & Removal:
Electric Meter Number:
Address or parcel number of the Recipient Property
Location of all existing & proposed buildings or structures on the Recipient Property
Drainage grades and elevations to assure water diversion will not occur to neighboring properties
Any additional information that may be required by the Building Inspector or the Planning Commission
Yes
Yes
Yes
No
Yes No
No
No
Where the building or structure will be located on the Recipient Property
Zoning District of the Recipient Property:
Larry Johnson Building Inspector (309) 932 - 2555 building_inspector@galvail.gov
Myron Townsend Superintendent of Streets (309) 932 - 2555 street_supervisor@galvail.gov
Greg Thompson
Water/Wastewater
Superintendent
(309) 932 - 2555 water_supervisor@galvail.gov
Jerry Clark Chief of Police (309( 932 - 3911 police_chief@galvail.gov
Ameren (888) 659 - 4540
Gas Meter
Electric Meter
Telephone Service
Cable
Office Use Only
Verify Disconnection & Removal
Telephone Company
Cable Television Company
City of Galva Water & Wastewater Department
Page 3 of 3
For your convenience, a summary of the building or structure moving process and requirements is listed below.
File a letter with the City Clerk's office requesting approval to move a building or structure within the City's limits.
Complete a "Building / Structure Moving Permit Application."
Provide the City Clerk's office with a performance bond in an amount determined by the inspector, but not less than $25,000
dollars which indemnifies the City for any costs or expenses incurred by the City related to the moving process.
Contact the City at (309) 932 - 2555 to schedule an inspection of the donor & recipient property. The inspector will provide a
report identifying any construction requirements or changes to the building and/or to the donor property or recipient
property.
Provide the City Clerk's office with insurance certificates naming the City of Galva as an additional insured or certificate
holder, evidencing that the applicant has public liability insurance coverage of not less than $500,000 per person and not less
than $1,000,000 per incident (accident), plus property damage insurance coverage of not less than $500,000.
Additional regulations for moving a structure or building within the corporate limits of the City of Galva follows:
1. DAMAGED BUILDINGS - No building shall be repaired, altered or moved within or into the municipality that has deteriorated or has
been damaged by any cause (including such moving and separation from its foundation and service connections in case of moved
buildings) fifty (50) percent or more of its equalized assessed value.
2. CONTINUOUS MOVEMENT - The movement of structures or buildings shall be a continuous operation during all the hours of the
day, and day by day and at night, until such movement is fully completed. All of such operations shall be performed with the least
possible obstruction to thoroughfares. No building or structure shall be allowed to remain overnight upon any street crossing or
intersection, or so near thereto as to prevent easy access to any fire hydrant or any other public facility. Lighted lanterns shall be kept
in conspicuous places at each end of the building during the night.
3. STREET REPAIR - every person receiving a permit to move a building or structure shall, within one day after said building or
structure reaches its destination, report that fact to the City Clerk's office who shall request the applicant, in the company of the
Supervisor of Streets, inspect the streets and highways over which said building or structure has been moved for the purpose of
ascertaining their condition. If the removal of said building or structure has caused any damage to any street or highway, the person
to whom the permit was issued shall forthwith place them in good repair as they were before the permit was granted. On the failure
of the said permittee to do so within ten (10) says thereafter to the satisfaction of the governing body, said body shall repair the
damage done to such streets and highways and hold the person obtaining such permit and the sureties on his bond responsible for
the payment of same.
4. CONFORMANCE WITH CODE - No permit shall be issued to move a building or structure within or into the City of Galva and to
establish it upon a location within the municipality until the City's Inspector has made an investigation of such building or structure at
the location from which it is to be moved and is satisfied from such investigation that said building or structure is in a sound and
stable condition and of such construction that it will meet the requirements of the City's Building Code in all respects. A complete
plan of all further repairs, improvements and remodeling, with reference to such building or structure, shall be submitted to the
Inspector, and the Inspector shall make a finding of fact to the effect that all such repairs, improvements and remodeling in the
building or structure are in conformity with the requirements of the City's Building Codes and that when same are completed, the
building or structure, as such, will so comply with the City's Building Code.
5. SITE SECURITY - The Inspector may require the permittee to erect barriers around an excavated site to prevent accidental falling
therein of travelers, residents, or children.
6. INTERFERING STRUCTURES - Whenever is shall be necessary to interfere with wires or cables of a public utility, the terms of any
special or franchise ordinance governing shall apply and the bond therein specified shall be given. If no such terms apply, the the
Street Supervisor shall estimate the expense of fixing the wires and the bond to be given to cover this. When any such moving
building or structure shall approach any fire alarm wire or pole which shall be endangered by the removal or said building or
structure, it shall be the duty of the mover to notify the Chief of the Fire Department at least six (6) hours before reaching such such
wire or pole so that they may be removed or cared for by the authorities of the Municipality.
CERTIFICATION: As applicant, I hereby certify that I will follow all rules, regulations and policies laid down by the City of Galva and will
adhere to all laws, whether they be local, state or federal, when moving a building or structure within the corporate limits of the City
of Galva, Henry County, Illinois.
Signature of Applicant: Date:
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BuildingMovePermit Customer Satisfaction Survey

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Completed 12 July 2020

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