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3. Date of Application*
   Date of Application
5. Applicant First Name*
6. Applicant Last Name*
8. Address
10. City
11. State
12. Zip Code
14. Phone Number*
16. Location of Demolition*
18. Type of Structure and Method of Demolition
20. Please read before submitting
    Demolition Permit Rules and Regulations
22. Acknowledgement*

    By checking this box, I acknowledge that I have read the City's Demolition Requirements and will comply fully with these regulations and all other laws of the City of Huber Heights

    1. City of Huber Heights Demolition Requirements
24. Demolition Permit Fee

    $40

    After submitting this form, you will be automatically redirected to the online payments page.

26. Electronic Signature Agreement*

    By checking the "I acknowledge" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I acknowledge.
28. Electronic Signature
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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field