Forms • McCook, NE • CivicEngage

DEMOLITION PERMIT APPLICATION

Leave This Blank:

PERMIT FEE: $100.00

Job Address:*

Property Owner Information

Name:*

Address:*

City/State/Zip:*

Phone:*

Email address:

Owner's Electronic Signature:

Date:

Contractor Information

Business Name:

Address:

City/State/Zip:

Phone:

Email address:

Contractor's Electronic Signature:

Date:

Is Contractor licensed?

Yes

Type of work:*

	House
	Garage

	Storage
	Other

If other, please explain:

Description of Work*

Total Project Cost:*

***ATTACH CERTIFICATE OF ASBESTOS INSPECTION***

* indicates required fields.