Building & Zoning Department
215 S. Broadway, Louisburg, KS 66053
913-837-5811 · louisburgkansas.gov
rwhitham@louisburgkansas.gov
APPLICATION FOR DEMOLITION
Date: _____________ Permit # ______________________________
Applicant Name: ____________________________________________________________________________________
Property Owner: ____________________________________________________________________________________
Property Owner Address: _________________________________________ Phone: _____________________________
Contractor Name (if applicable): ________________________________________________________________________
Contractor Address: _________________________________________________________________________________
Contractor Phone: ___________________________________________________________________________________
Describe work being done: ____________________________________________________________________________
__________________________________________________________________________________________________
Describe present use of structure: ______________________________________________________________________
__________________________________________________________________________________________________
Work being done by: _________________________________________________________________________________
Does structure have sanitary facilities? _____ Yes _____ No
I, ______________________, hereby certify that the information provided herein is true and correct and that all
improvements shall comply with the City of Louisburg’s Zoning Regulations, Subdivision Regulations and Building Codes. I
further understand any permit obtained by false or incorrect statements of fact material to the issuance of the permit
shall be null and void.
Date: _____________ Signature: __________________________________________________
Office Use Only
___________ Fees Paid/Amount ___________ Receipt ___________ Date Issued
Demolition address: _________________________________________________________________________________
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome