HOUSING/BUILDING MOVING PERMIT APPLICATION

CITY OF WEST LIBERTY

409 N. Calhoun Street - West Liberty, IA 52776 Phone: (319)627-2418 Fax: (319)627-4847
House/Building Moving Permit Application
Application Date

MonthDayYear
Date
Required Fees & Bonds

Fee:$400.00

Surety Bond: $2,500
Property Owner
Owner Address
Owner Phone
Site Address
Moving Date

MonthDayYear
Date
Moving Company
Company Address
Company Phone
House/Building Dimensions
Route Specifications (City Limits)
It shall be the responsibility of the mover to notify all utility companies.

A CERTIFICATE OF INSURANCE is required by city code Title 3-4-2. The applicant shall show evidence that he/they are insured for not less than one million dollars ($1,000,000) for personal injuries and one million dollars ($1,000,000) property damage.
Signature of Applicant

Clear
Should be Empty:

House/Building Moving Permit Application