Application for Demolition Permit

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Code Enforcement

Application for Demolition Permit - City of Murphysboro Public Works

Address of Structure

Lot

Block

Subdivision

Lot Size

Parcel ID #

Type of Structure

Size of Structure

Cost of Demolition

Existing Basement?

Yes

Party Walls?

Yes

Septic System on Property?

Yes

Well or Cistern on Property?

Yes

Owner of Property

First Last

Mailing Address

Street Address City State ZIP Code

Phone

Contractor Performing Work

First Last

Mailing Address of Contractor

Street Address City State ZIP Code

Phone Nuber of Contractor

By affixing my signature below, I certify that I have received a copy of the City of Murphysboro Demolition Requirements. As owner and/or representative I hereby certify that the proposed work will be conducted in a manner that conforms to all applicable laws.

Signature(Required)

First

type your full name here to sign

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