RAPHO TOWNSHIP DEMOLITION PERMIT APPLICATION
Date: _______________________ Permit # ____________________
APPLICANT NAME___________________________ ADDRESS ___________________________________
CITY ___________________ STATE _____ ZIP________ PHONE_____________ CELL______________
OWNER NAME/ADDRESS __________________________________________________________________
PARCEL ADDRESS _____________________________________________ PARCEL # 540-_____________
CONTRACTOR NAME _____________________________________________________
CONTRACTOR ADDRESS__________________________________________ PHONE__________________
COST OF DEMOLITION $_________________________ PERMIT FEE ($3/thousand) $____________
STRUCTURE USE: ( ) commercial/industrial ( ) residential ( ) recreational ( ) accessory
LOT SIZE: _______________________________ (1 acre equals 43,560 square feet)
NOTE: Prior to any excavation or earthmoving on the site, an adequate erosion & sediment pollution
control plan must be developed, implemented and maintained.
Demolition includes proper disposal of all materials according to state law. Demolition site shall be
cleared of all demolition debris within three months of date of permit.
The applicant alone bears the responsibility of insuring that his/her lot, structures, and uses thereon, do not
violate laws, regulations, or rights of neighbors and other parties. Applicant acknowledges that he/she has not
relied on any oral or written statements of any officer of Rapho Township as to any matters other than zoning.
I hereby certify that the information submitted in accordance with this application is correct, that I am the
property owner or have permission from the property owner to submit this application.
Applicants Signature Date