Form Center

2. *DEPARTMENT USE ONLY

   PERMIT NO:___________________________

   DATE ISSUED:__________________________

   ZONING:_______________________________

6. Application Date:*
   Application Date:
8. Site Address1*
10. Lot #:
11. Parcel #:
13. Located between:(street names)
15. Zoning District:
16. Flood Plain Zone:*
    -- Select One --YESNO
17. Development permit #:
19. Description of Demolition Activities:*
21. Estimated Start Date:
22. Estimated Finish Date:
23. Estimated Cost: $*
25. Type of Structure:*
    -- Select One --MasonaryWood FramePost and BeamOther
26. Type of Heat:*
    -- Select One --Natural GasElectricFuel OilPropane
28. Utilities in Use: Choose all that applies*

    1. Natural Gas
    2. Water
    3. Electric

    1. Cable TV
    2. Telephone
    3. Other
29. Other:
31. Residential:*
    -- Select One --One FamilyTwo FamilyThree FamilyFour or MoreNot Residential
32. Commercial:*
    -- Select One --YesNo
33. Mixed Use
    -- Select One --YESNO
35. Applicant Name:*
37. Applicant Address:*
38. Applicant Address2:
40. City
41. State
42. Zip
44. Applicant Phone No:*
45. Applicant Email:*
47. Demolition Contractor Name*

    Note: All contractors must be registered with the city.  If more that one contractor please provide a list of contractors including name, address, phone number and work providing.

48. Registration No:
50. Contractor Address:*
51. Contractor Address2:
53. City
54. State
55. Zip
57. Phone No:*
58. Contractor Email:*
60. Property Owner Name:*
62. Property Owner Address:
63. Property Owner Address2:
65. City
66. State
67. Zip
69. Property Owner Phone No.
70. Property Owner Email:
74. Applicant must comply with the following requirements to be issued a permit:
76. STEP 1- Contact all utility service providers including city utility departments and request to have all services disconnected and removed from the property. The following checklist is provided for your reference and verification.

    1. Sewer Line Located
    2. Notify Lancaster Utilities Collection (687-6627) & request termination of account(s)
    3. Water meter(s) removed and tap disconnected (Water Dept. call 687-6631)
    4. Gas meter(s) removed and tap disconnected ( Gas Dept. 687-6670)
    5. Electric service equipment & drop cable removed (AEP or South Central)
    6. Telephone cable(s) removed- notify telephone service provider (SBC)
    7. Cable TV cable(s) remove drop cable (T. W.)
78. The following applies to commercial and multiple residential demolitions only:

    Every demolition of a facility requires EPA notification regardless of whether asbestos is involved. Renovation of a facility must be submitted to the EPA when the amount of regulated asbestos-containing material (RACM) stripped, removed, dislodged, cut, drilled, or similarly disturbed exceeds 260 linear feet on pipes or 160 square feet on other facility components or 35 cubic feet of facility components. A signed EPA permit application (OEPA Notification of Demolition and Renovation) will be required before the City of Lancaster Building Department issues a Demolition Permit. Contact the Ohio EPA-Division of Air Pollution Control for compliance requirements at (614) 644-2270 or (www.epa.state.oh.us/dapc/files/files.html)

80. STEP 2- Submit application(s) and all information required in step 1 to the Building Department

    1. Provide site plans (last page) detailing the lot dimensions, location of all structures and distances between structures and lot property lines. Indicate structure(s) to be demolished.
    2. If equipment or any work requires occupying the street, alley or sidewalk, a permit to “Use Public Right-of-Way” form must be completed and approved. A plan for pedestrian and vehicle traffic control at the site should be included with the application.
    3. Provisions must be made and in place for water to control dust during demolition. Discuss water sources with the Water Department.
    4. The entire demolition site should have safety fencing installed to keep juveniles and on-lookers a safe distance from all activities and security when operations are shut down during the night.
    5. The Ohio Utilities Protection Service (800-362-2764) must be notified two-working-days prior to demolition & excavation activities per State Law.
    6. Supply all documents and verify compliance with all of the above items and submit to the Building Department for review. After the application is reviewed and approved, you will be notified and asked to pick up your permit. After the permit is issued, you will be permitted to begin demolition.
82. STEP 3- After the structure is demolished

    1. After the permit is issued and the structure has been removed, the sewer line must be located. Inspections by the Building Department of the sewer capping and encasement must be made prior to backfilling.
    2. All materials and debris must be removed from the site. Any mud tracked onto the road must be cleaned-up.
    3. The empty lot must be leveled out and graded before removal of the security fence and final approval is issued for the property.
86. Certifications: Read all sections, Sign & Date

88. I fully understand that no excavation, construction, demolition, of any structure shall be undertaken or performed until the permit applied for herein has been approved and issued by the City of Lancaster Building Department.

    I hereby certify that I am the owner of the named property, or that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application as his/her authorized agent. In addition, if this permit is issued, I certify that the code official shall have the authority to enter areas covered by such permit to enforce the provisions of the code applicable to such permit.

    I hereby acknowledge that I have read and fully understand the instructions that are explained on page two of this application and agree to comply with the instructions as written or orally given by the Building Department for this project.

90. Signature:*
91. Date:*
    Date:
93. UPLOAD ANY SUPPORTING DOCUMENTS:

    Or email plans to buildingsubmittal@ci.lancaster.oh.us or building@ci.lancaster.oh.us

97. Building Department Use Only

    Inspector Check List

    (Prior to Issuance of Permit)

       *Water Meter(s) Removed         *Electric Drop(s) Removed         *Cable TV Drop(s) Removed         *Gas Meter(s) Removed         *Telephone Drop(s) Removed 

    Inspector Approval to Proceed: _______________________________     Date: ______________

Leave This Blank:


98. 1. Receive an email copy of this form.
99. Email address

    This field is not part of the form submission.

100. Submit

* indicates a required field