Proposed Date to
Begin Demo.:
Date Notified
Gas
Water & Sewer
Electric
Comments
Approved By: Date: Permit #:
Bus. License #:
Utility
Disconnect
Notifications:
Contractor's Address:
DEMOLITION PERMIT
APPLICATION
CITY OF MURRAY, KENTUCKY
500 Main Street
Murray, KY 42071
Phone: (270) 762-0300
Fax: (270) 762-0331
Zip:
State:
City:
Commercial □ Residential
Address:
Demolition Type: □ Voluntary □ By Municipal Order
Electric Company used for this location: □ Murray Electric System □ West KY Rural Electric
City:
State:
ALLOW UP TO 14 DAYS FOR APPROVAL. NO WORK SHALL BEGIN WITHOUT APPROVED PERMIT
Please describe any and all structures that are to be demolished, including accessory structures:
Is there a possiblilty that a structure be reconstructed in the future:
Zip:
Contractor:
Owner Address:
Phone #:
Approved By/Work Order No. & Date
Phone #:
OFFICIAL USE ONLY
Owner:
Deed Book: Page #:
Owner's Signature: Date:
I hereby certify that I am the owner of the above property. I agree to conform to all applicable laws of this jurisdiction
and the State of Kentucky. I acknowledge that the demolition of structures, may require that an asbestos survey to be
cond
ucted by a certified asbestos abatement contractor. I acknowledge that approval must be obtained from the
Kentucky Division of Air Quality, where applicable. It is the responsibility of the owner or contractor to call
Environmental Protection Agency at 270-898-8468 for regulations. I acknowledge that I will abide by all safeguards
required by the 2012 International Building Code.