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MOVING PERMIT AND APPLICATION
CITY OF IOWA CITY
Moving Permit No. ____________
Moving Permit Fee ____________
Application Date ______________
Date Issued __________________
Building Address __________________________________ Existing Use _____________________________
Owner ___________________________________________________________________________________
Phone Number ______________________________
Mover ___________________________________________________________________________________
Phone Number ______________________________
Address of Relocated Structure _______________________________________________________________
PRINCIPAL TYPE OF FRAME DIMENSIONS
Masonry Structural Steel Loaded Height ______________________________
Wood Reinforced Concrete Loaded Eave Height _________________________
Other:__________________Loaded Width (Including Overhang) ___________________
Loaded Length (Including Overhang) __________________
Loaded Weight & No. of Axles __________________
Proposed Moving Date: _______________ From: _____________ AM/PM To:____________AM/PM
Proposed Routing __________________________________________________________________
_________________________________________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________
__________________________________________________________________________________
NOTICE: This application, along with fees and deposits, must be filed at least forty-
eight (48) hours in advance of the move or a permit CANNOT be issued.
I hereby certify that I have read and examined this application and know the same
to be true and correct. All provisions of laws and ordinances governing this type
of work will be compiled with whether specified herein or not. The granting of a
permit does not presume to give authority to violate or cancel the provisions of any
other state or local law regulating construction of the performance of construc-
tion.
X_____________________________________________ ___________________________________
SIGNATURE OF APPLICANT (DATE) SIGNATURE OF BUILDING OFFICIAL
OTHER UTILITIES
Telephone Co.______________________________________________________________________
Gas & Electric ______________________________________________________________________
Cable Television ______________________________________________________________________
Other ______________________________________________________________________
STATEMENT OF EXPENSE INSURED AS A RESULT OF MOVING
Building Address Existing Use ____________________
Owner __________________________________________________________________________________
mail address zip
Mover __________________________________________________________________________________
mail address zip
Address of Relocated Structure ______________________________________________________________
Div. Head Estimated Amount Amount
Expenses Initial Expenses Deposited Expenditures Due Returned
Traffic Eng._______$ X2 =$ -$ = $_______ $________
Police _______$ X2 =$ -$ = $_______ $________
Fire _______$ X2 =$ -$ = $_______ $________
Forester _______$ X2 =$ -$ = $_______ $________
Other _______$ X2 =$ -$ = $_______ $________
This move has been completed in accordance with the Codes and procedures
of the City of Iowa City and accountants may close the escrow.
Conditions _____________________________________________________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________
__________________________________________________________________________________
_________________________________________________________________________________
____________________________________
(S) Building Official
______________________________________Amount returned _____________________________
(S) Comptroller
______________________________________Amount collected ____________________________
Date