\\city-hall\Municipal Services\Codes\Permit - CODES\Demolition\DEMOLITION APP FORM.docx 6/30/2017
DEMOLITION PERMIT
A
PPLICATION
PERMIT NO._______D-_______
DATE OF APPLICATION:_________________________
Permission is hereby granted to the above mentioned demolition contractor to
demolish a Building/Residence, etc. at ______________________________________,
legal description being ___________________________________________________
_____________________________________________________________________
_____________________________________________________________________.
Current building has been used as a _____________________________ of _________
story(ies), and is approximately ___________feet wide, and ______________feet deep.
Landfill debris is being hauled to:__________________________________________.
Has a permit been issued for a new building on this site? Yes No
I hereby affirm that the above statements are true and correct, and bind myself to
comply with all ordinances pertaining to or governing the demolition of buildings.
Applicant Signature:
Title:
Approved by Codes Administrator:
Date:
THIS PERMIT IS VALID FOR SIXTY (60) DAYS.
SEWER CAP INSPECTION MUST BE CALLED FOR PRIOR TO
COVERING.
Property Owner:
Address:
Contractor:
Address:
City of Junction City Building & Codes
700 N Jefferson St, PO Box 287, Junction City, KS 66441
P: 785-238-3103 Ext: 182 F: 785-210-1904
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