Who provides water service to this property (Whether currently active or not)? ___________________________
*If water is provided by Des Moines Water Works, you must provide one of the following items from DMWW –
Des Moines Water Works “TAPS CUT AT MAIN” Report
Or
Application to Stub and Reuse Water Service Line completed by DMWW.
Your permit to demolish will not be issued until Polk County Public Works is in receipt of one of the above items
if served by DMWW.
*The demo permit will not be issued until staff has reviewed the permit application.
Date of Application:______________________ Permit Fee: $82.00
Property Address:_______________________________________________________________________________________________
District Parcel or GeoParcel(if no known address)
_____________________________________________________________________________________________________________
Property Owner:____________________________________Email:___________________________ Phone: _____________________
Owner’s Address:_______________________________________________________________________________________________
Contractor :________________________________________Email:__________________________ Phone: _____________________
Residential Commercial
Is the property on septic? YES NO
Brief Description of the Demolition
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
I understand work must commence within 180 days from the permit issuance date, and be completed and inspected within one year from the issue
date, or this permit will be null and void.
I understand all work must be inspected and approved by Polk County I must call for the final inspection on the demolition permit. I further understand
that a Certificate of Compliance is required in accordance with applicable codes and ordinances.
________________________________________ __________________________
Signed Date
Polk County Public Works
5885 NE 14th St. Des Moines, IA 50313
Ph: (515)286-3705 Fax: (515)286-3437
APPLICATION FOR DEMOLITION
Permit #______________________
click to sign
signature
click to edit
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