CITY OF CANTON, KANSAS

BUILDING PERMIT APPLICATION

($15.00 for cost up to $10,000 + $1.50 per $1,000 cost over $10,000)

1. Purpose of Permit: ____ Construction ____ Demolition ____ Other

Explanation of Other: ______

2. Name of legal owner of lot or tract of ground: ______

(If applicant is a corporation or partnership, give name of business and/or entity and name of individual.)

______

3. Legal description and/or street address of building or structure: ______

______

4. Contact info:

Name of person/company performing work: ______

Homeowner or contractor. (circle one)

Address of person/company performing work:______

______

Best contact phone #:______Email:______

(if contractor, proof of bond or liability provided:____yes _____no)

7. Estimated cost of work: ______

8. Date work will commence: ______

9. Type of building work proposed: ______

10. Outside dimensions of building by floors and dimensions of basement (if any): ______

11. Class of occupancy: (Residence, Shed, Garage, etc.) ______

12. Class of construction: (Wood, Concrete, etc.) ______

13. Type of materials to be used:

walls ______

floors ______

ceilings ______

roofs ______

foundation ______

14. Expected date of completion of construction not to exceed one year from date of issuance of permit: ______

15. Other information pertinent to issuance of required permit: ______

______

Attach the following:

  1. A blue print of the structure to be built

2. A plan of the lot or parcel of land drawn to scale, showing theidentification and location of the lot or parcel and actual dimensionsof the area, where appropriate, certified by a land surveyor or civilengineer as a true copy of the registered or recorded plat of such land

3. A plan of the lot or parcel of land, drawn to scale, showing theboundaries of the land or parcel; the ground area; building lines inrelation to lot lines; height and bulk of all existing and proposedbuildings and structures; the use to be made of the buildings and structures; front, side, and real elevations of the buildings andstructures as located on the property; locations of surroundingbuildings and structures as located on the property; locations ofsurrounding buildings and structures and profiles of the frontage;streets and right-of-way giving access to the property; drivewaysand parking areas; parking and loading spaces.

4. Other information as may be necessary to the administrative officer for the proper administration and enforcement of the zoning regulations.

Notes:

Please allow up to 10 business days for review and approval/disapproval of building permit.

Completed applications may be faxed to 620)628-4354, emailed to , dropped off at City Hall, 100 s Main, or mailed to PO Box 476.

______

DateSignature of Owner or Contractor

______

Office Use Only:

______Received via: fax email postal mail city hall

Date Received (circle one)

This building permit application is:

ApprovedNot Approved

Reason for disapproval:

______

______

______

______

______

______

Date , Building Inspector