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2. DEMOLITION PERMIT APPLICATION
4. Permit Fee: $65.00
6. Application fee will be collected upon acceptance of your application. This is not the demolition permit. Please allow a minimum of 3 business days for review of the application and the demolition permit to be processed
8. PROPERTY INFORMATION
10. Property Address*
12. Owner First Name*
13. Owner Last Name*
14. Owner Phone Number*
16. Mailing Address*
18. City*
19. State*
20. Zip*
22. CONTRACTOR INFORMATION
24. Company Name*
26. Mailing Address*
28. City*
29. State*
30. Zip Code*
32. Contact Name*
33. Contact Phone Number*
34. Contact Fax Number
36. Structure Information*

    1. Single Family
    2. 2 Unit Residential

    1. 3 & 4 Unit Residential
    2. 5 + Unit Residential

    1. Commercial
    2. Accessory
38. Width
39. Length
40. Height
41. Total Square Feet
43. *Sewer and Water services MUST be disconnected and inspected before hole is filled. *Safety measures shall be in during duration of demolition.
45. The permit holder shall give notice to all public utilities affected and shall take all proper precautions to avoid damage to any such utility or to the City of Le Mars. The permit holder understands that disconnected water and sanitary sewer service lines must be properly plugged, capped or removed and inspected by the Water Superintendent and the Wastewater Superintendent and/or the Assistant Wastewater Superintendent. The City of Le Mars requires that all debris including foundation walls, footings and basement floors be removed before the hole is filled.
47. I have reviewed the permit application packet and attest that the above information is correct

    1. I agree
    2. I disagree
49. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
51. Electronic Signature
53. Water Department: 546-5555 Wastewater Department: 546-5003
Leave This Blank:


56. 1. Receive an email copy of this form.
57. Email address

    This field is not part of the form submission.

58. Submit

* indicates a required field