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Demolition Permit Escrow Refund Request

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This form has been modified since it was saved. Please review all fields before submitting.

Instructions
Please fill out this form to request a demolition permit escrow release. Fill out one form for each address being requested.
Permit Number*
Escrow Refund Amount*
Project Site Street Address*
Contractor Company Name*
Contractor Mailing Address*
City*
State*
Zip Code*
Contact Name for Questions*
Contact Email*
Contact Phone*