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MORGAN COUNTY PLANNING AND DEVELOPMENT Post Office Box 1357 150 East Washington Street, Suite 200 Madison, Georgia 30650 (706) 342-4373 Office (706) 343-6455 Fax Property Information Owner: Phone Address: City: State: Zip Code: Demolition Contractor Name: Phone Address: City: State: Zip Code: Structure Information: Type: Material: Approx. Age: Square Footage of Structure: Method of Demolition: Disposal Information: Location Receiving Debris: Precautions taken for hazardous materials (if applicable): Lead present: Y N Asbestos: Y N Other: Estimated Start Date: Completion Date: **Note: Applicant must provide copies of weight tickets from disposal location** Permit Fee: $35.00 (flat fee) I verify that all demolition and disposal procedures have or will comply with all applicable federal, state and local regulations. Print Name: Signature: Date: DEMOLITION PERMIT APPLICATION FEE MUST ACCOMPANY THIS FORM INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED