Forms • McCook, NE • CivicEngage

PERMIT FEE: $100.00

Applicant Information

Name:*

Address:*

City/State/Zip:*

Phone:*

Email address:

Current building location (address):*

Legal Description:

Proposed location (address):*

Legal description:

Current use of building:

Estimated age of building:

Do you currently own this building?

Yes

No

If not, current owner:

Do you currently own the proposed lot?

Yes

No

If not, current owner:

Moving Contract Information

Business name:

Address:

City/State/Zip:

Phone:

Email address:

Is the Contractor licensed?

Yes

No

Describe the route by which the building will be moved:

Will power lines need to be moved?

Yes

No

Will telephone lines need to be moved:

Yes

No

Will CATV lines need to be moved?

Yes

No

Will tree limbs need to be cut?

Yes

No

Will lawns or scrubs be affected?

Yes

No

Total estimated cost of the move; include moving, repairs, remodeling, temporary utility relocations, site improvements, etc.

Does application comply with the City Code and Council policies?

Yes

No

If not, state exceptions:

Termite Inspection

You are required to have the building inspected for termites as a part of this application. Please attach a copy of the report.

Building Inspection Report

Each building to be moved shall be inspected by a Certified Inspector as a part of this application. A copy of the report must be attached.

Pictures of the structure

Take pictures (must be current) of the front, side and rear of the building and attach.

Pictures of the new location

Take pictures (must be current) of the lot and adjacent structures to which the building is to be moved.

Please estimate and itemize the cost of all repairs and improvements to be made to the structure at its proposed new location.

ITEM

COST

EXTERIOR:

$

INTERIOR

$

ELECTRICAL

$

PLUMBING

$

SITE WORK

$

TOTAL ESTIMATE

$

* indicates required fields.

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