City of Byron - Demolition Application

Demolition Permit Application
Date: *

MonthDayYear
Date
PermitNo. *
JOB SITE ADDRESS:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type ofStructure:*
Zoning District: *
Map& Parcel:*
Descriptionof Work : *
Property Owner
Name:*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Demolition Contractor
Name:*
Occupational Tax#:*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where will debris betaken?
Will there be any mitigation requiredfor asbestos or mold?

YesNo
If “yes”, provide mitigation report.
Are there any other structures on the property?

YesNo
Is the project site or the area of proposed land disturbingactivity with 200 feet of State waters?

YesNo
Notice: No changes shall be made from that which is stated in this application, or in attached plans and specifications, except by submitting a revised application, plans and/or specifications and receiving approval of the Chief Building Official for such change. Granting of a permit shall not be construed as a permit for or an approval of any violation of the Building Code or any other state or local law regulating construction or the performance of construction. I hereby certify that I have read and examined this application and the information provided herein is true and correct. I further certify that all work will comply with City Ordinances and regulations.
Signature of Owner/Contracter *
Date*

MonthDayYear
Date
Please verify that you are human*
FOR OFFICE USE ONLY
Construction Type:
Heated
Sq. Footage
Unheated
Unheated
TOTAL
TOTAL
Code Official Signature:
Occupancy:
LDP Required:

YesNo
Valuation Multiplier
Valuation $
Administrative Fee:
$
Building PermitFee:
$
Plan Review Fee:
$
CO Fee:
$
Total Fee:
$
Should be Empty:

Demolition Permit Application

Property Owner

Demolition Contractor

FOR OFFICE USE ONLY