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Revised: October 2021 1 Demolition Permit Application 101 N. 4th Street / P. O. Box 1030 Douglas, Wyoming 82633 [PHONE REDACTED], Fax: [PHONE REDACTED] Site Address Lot Block Subdivision Zone Owner Address City Zip Code Telephone No. Contractor Address City Zip Code Telephone No. Email: Type of Demolition: Residential Commercial Partial Complete Other Size of Building: sq. ft. Dimensions: Number of Stories: Flood Zone Designation: Anticipated Start Date: Anticipated Completion Date: Method of Demolition: Landfill disposal charges per dump truck load refer to Section 13.64.030 of the Douglas Municipal Code. Debris to be disposed of: *Anticipated Number of Loads: Future Plans for the Property: Safety Precautions: Special Conditions: Inspections (Place date & initials if inspected) Sewer Line Capped Water Line Capped Date: Date: Backfilling Final Date: Date: Called for Locates Utilities Located Date: Date: Utility Lines/Wires Removed Date: I certify that I am the owner, or am acting as the owner’s authorized agent, and the application and documents contained with this application are complete and accurate to the best of my knowledge, information and belief. Proof of ownership must be attached. Signature of Owner/Agent Date Signature of Contractor Date Authorized by Building Official Authorized by Public Works Supervisor Routing: Building Official Finance Public Works Police Dept Comments (For Office Use) SIGN SIGN SIGN SIGN ---PAGE BREAK--- Revised: October 2021 2 DEMOLITION PERMIT APPLICATION INFORMATION & REQUIREMENTS • Demolitions must be performed by a Contractor licensed by the City of Douglas. • Unless the water and sewer connections will be immediately used for replacement construction, the sewer line must be capped off five feet from the property line by filling it with concrete. The water line must be cutoff at the curb stop valve and capped or crimped. This process must be inspected by the Building Official (358-2132) or the Water & Sewer Supervisor of Public Works (358-9750). NOTE: If this is done on a weekend or after business hours, there will be a $50.00 call out fee for the inspection. If an inspection has not been requested and the job is completed, it will be the responsibility of the contractor or owner to re-excavate the trench for inspection purposes due to the hazard non-capped service lines can cause. • Application for disconnection of water, sewer and sanitation services, closure of accounts, and payment of landfill fees must be handled at the Finance Department located in City Hall (101 N. 4th Street) prior to demolition. Utility charges for water, sewer and sanitation services will be assessed through the end of the month of disconnection. Other utilities, (gas service, electricity, etc.) should be contacted at their business offices. NOTE: If a new building is being constructed following the demolition, a separate building permit must be obtained. The city may require additional inspection of the water and sewer service lines, or installation of lines. • All other utility companies (electrical, gas, telephone, and cable TV) must be notified and all utility lines or wires disconnected and removed prior to obtaining a demolition permit. • State law requires anyone who will be excavating with power equipment to provide advance notice to all notification centers serving the area. Notice is to be given at least two full business days prior to beginning to work. To call for locates: Wyoming One-Call 1-[PHONE REDACTED] or 811 Excavator’s Handbooks are available at City Hall, or by calling the one-Call Center. Public Safety and Convenience The contractor shall be responsible for protection of life and property during the demolition and removal of structures. The contractor shall provide and maintain such barriers, lights, and protective devices as indicated by the city. The work shall be conducted with the least possible obstruction or inconvenience to pedestrians, vehicular and other traffic. Demolition shall be performed in a timely manner that avoids damage or destruction to private or public property. Any impact on private or public property shall be restored as safe and permanent as before the demolition commenced. Liability of Contractors The contractor shall assume full responsibility of the work, whether performed by the contractor, his employees, or any subcontractor. All losses resulting from the character of the work, weather, fires or other causes shall be at the contractor’s expense. Foundations, Footings, & Basements All underground installations, including foundations, footings and basement floors, must be removed. In-ground pools must have all walls removed and the bottom of the pool broken up to allow for drainage. An inspection is required before backfilling. Debris/Landfill fee schedule Loads must be covered in transit. Construction and demolition debris disposal shall be subject to the fees listed in Section 13.64.030 of the Douglas Municipal Code. Note: Asbestos cannot be accepted at the landfill. Contact Public Works at 358-9750 for other methods of disposing of asbestos.