DEPARTMENT OF PLANNING AND NATURAL RESOURCES ENVIRONMENTAL PROTECTION
DEPARTMENT OF PLANNING AND NATURAL RESOURCES ENVIRONMENTAL PROTECTION CONSTRUCTION AND DEMOLITION DEBRIS WASTE MANAGEMENT PLAN ** Required to submit for approval prior to the issuance of a demolition permit. Project Site Address: ____________________________________________________ Demolition Organization: ___________________________________________________ Prepared by (Print): ______________________________________________________ Phone: _____________________________ Email: ________________________________________ Identification of Waste Materials: Lead /Asbestos: Other Demolition Materials: Identify diversion facilities where the construction and demolition waste material will be taken. Facility Reference Name and Address of Facility A B C D Identify construction & demolition waste materials that will be diverted from the landfill by recycling, reuse on the project, or salvage for future use or sale. …
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DEPARTMENT OF PLANNING AND NATURAL RESOURCES ENVIRONMENTAL PROTECTION CONSTRUCTION AND DEMOLITION DEBRIS WASTE MANAGEMENT PLAN ** Required to submit for approval prior to the issuance of a demolition permit. Project Site Address: ____________________________________________________ Demolition Organization: ___________________________________________________ Prepared by (Print): ______________________________________________________ Phone: _____________________________ Email: ________________________________________ Identification of Waste Materials: Lead /Asbestos: Other Demolition Materials: Identify diversion facilities where the construction and demolition waste material will be taken. Facility Reference Name and Address of Facility A B C D Identify construction & demolition waste materials that will be diverted from the landfill by recycling, reuse on the project, or salvage for future use or sale. Material Type Recycled(Tons)** Reused(Tons)** Salvaged(Tons)** Salvage(Tons)** Total Facility Used (A-D, etc.) Asphalt Concrete Brick Tile Scrap Metal Building Materials (Windows, Doors, Fixtures, etc.) Corrugated Cardboard Dirt/Clean Fill Drywall Carpet Pad (Foam) Glass (Plate/No Container) Unpainted Wood/Pallets Yard Trimmings, Brush, Trees, Stumps, etc. Garbage (Solid Waste, Trash, Rubbish, Food Waste, etc.) Asphalt Shingle Concrete Tile Tar and Gravel Wood Shingle Other: Approved By: ________________________________________________________ Date: ________________________________________ GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF PERMITS STX DISTRICT TEL: (340) 773-1082 STT/STJ DISTRICT TEL: (340) 774-3320 APPLICATION for DEMOLITION PERMIT Submit a Site Location Map and Site Plan of building(s) or structure(s) to be demolished, proof of ownership, and photos (if required). PARCEL IDENTIFICATION NUMBER (PIN) A. LEGAL INFORMATION OWNER OF BUILDING/STRUCTURE: TELEPHONE NUMBERS: PROOF OF OWNERSHIP: ☐ DEED ☐ LEASES ☐ OTHER LOCATION OF WORK: PLOT NO.: ORIGINAL USE OF BUILDING: ☐ RES ☐ COM ☐ IND ☐ OTHER NUMBER OF STRUCTURES ON PARCEL TO BE DEMOLISHED: PLANS REQUIRED: ☐ YES ☐ NO ESTIMATED COST OF DEMOLITION: $ B. DESCRIPTION OF BUILDING 1. OVERALL DIMENSIONS: 6. NO. OF STORIES: 2. APPROX. AGE OF BUILDING: 7. ABATEMENT REQ’D: ☐ YES ☐ NO 3. 1st FLOOR AREA: 8. SIZE OF LOT: 4. TYPE OF ROOFING: 9. TYPE OF WALLS: 5. TYPE OF FLOOR: 10. PHOTOS ATTACHED ☐ YES ☐ NO DISTANCE FROM ADJACENT BUILDINGS: DISTANCE FROM ADJACENT BOUNDARIES: ☐ PARTIAL DEMOLITION ☐ TOTAL DEMOLITION (PHOTOS REQUIRED) PERSON CONDUCTING DEMOLITION: REMARKS: SIGNATURE OF OWNER: DATE: