Page 2 of 3 4/4/14
In case of emergency, vandalism, or any other need to contact someone, please list at least 1 (one) On-Site/After
Hours Emergency Contact for the City of Junction City Police or Fire Departments to contact if necessary.
On-Site/After Hours Emergency Contact: 1.__________________________________________________________
Phone Numbers: ______________________________________________________________________________
On-Site/After Hours Emergency Contact: 2.__________________________________________________________
Phone Numbers: ______________________________________________________________________________
On-Site/After Hours Emergency Contact: 3.__________________________________________________________
Phone Numbers: ______________________________________________________________________________
THE OWNER OF THIS BUILDING AND THE UNDERSIGNED AGREE TO CONFORM TO ALL APPLICABLE CODES OF THE CITY OF JUNCTION CITY AND/OR GEARY COUNTY, KANSAS. I CERTIFY
THAT THE FACTS AND INFORMATION IN THIS APPLICATION, INCLUDING ANY ATTACHMENTS, ARE TRUE, COMPLETE, AND ACCURATE TO THE BEST OF MY KNOWLEDGE. I FURTHER CERTIFY
THAT THIS APPLICATION DOES NOT CONTAIN ANY FRAUDULENT, MISREPRESENTED OR FALSE STATEMENTS.
______________________________________________ _____________________
Applicant Signature Date
Permit Application must be completed in its entirety with all required attachments and must be
signed by the applicant or it will not be processed.
PERMITS MUST BE POSTED ON THE JOB SITE AND VISIBLY SEEN FROM THE ROADWAY.
NOTE: An attachment must accompany this application showing, by surveyor’s certificate on an approved drawing, the location of the proposed
construction. The drawing must be signed by the applicant.
***OFFICE USE ONLY***
PARCEL ID:________________________________________________
Use Zone Plot Plan Flood Plain Elevation Site Insp. Record Meter Order
PLANS ZONING ENGINEERING TAXES PAID OFFICE
APPROVED BY:
METER FEES $__________________
__________________________________________________ PERMIT FEES $ __________________
Code Administrator Approval Date CRAFT FEES $ __________________
TOTAL FEES $__________________