Fillable Permit To Move Building 1 (City of Galena)

Fill Online, Printable, Fillable, Blank Permit To Move Building 1 (City of Galena) Form

Use Fill to complete blank online CITY OF GALENA (KS) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Permit To Move Building 1 (City of Galena)

On average this form takes 5 minutes to complete

The Permit To Move Building 1 (City of Galena) form is 2 pages long and contains:

  • 0 signatures
  • 0 check-boxes
  • 19 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Galena

BROWSE CITY OF GALENA (KS) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
The City of Galena, Kansas
APPLICATION FOR PERMIT TO MOVE BUILDING
This applica for a permit to move a house, building or other structure shall be filed with the
City Clerk. Simultaneous with the filing of said applica
on, the applicant shall pay a $10.00
building permit fee.
Applicant Name and Address:
First / Middle / Last
Number/Street City State Zip
Date and Hour of the proposed move and the proposed route:
Descrip
on of the house, building or other structure to be moved:
General Descrip
on:
Type of Structure: (example: mobile home, modular home, other)
Dimensions of Structure:
Type of exterior siding and roofing of the structure:
Extent of plumbing and electrical work in the structure:
Is it necessary to cut or raise wires or traffic signals, or move poles or other equipment?
Check One: Yes ___ / No ___. If the answer is Yes, the
n complete ques
on 5.
1.
2.
3.
4.
City of Galena, Kansas 211 W 7th Street, Galena, KS 66739 Phone: (620) 783-5265 FAX: (620) 783-5111
Please complete the following applicaon informaon:
CLEAR
SUBMIT
5. Name the owners of such wires, traffic signals, poles or other equipment specified in
paragraph 4, and the dates of such cu
ng, raising or removal as may be applicable.
6. BOND REQUIRED OR PUBLIC LIABILITY INSURANCE POLICY. All applicants for a permit
hereunder shall be accompanied by a bond to be approved by the governing body in an
amount not less than $25,000.00, condi d upon saving harmless the City of Galena
from any and all claims for personal injury or property damage caused directly or indirectly
by the applicant’s opera
ns under a permit granted hereunder, and condi d further
upon the payment by the applicant of any and all damage to person or property caused by
the negligence of the applicant, his or her agents or employees.
A public liability insurance policy, issued by an insurance company authorized to do
business in the State of Kansas, and conforming to this sec on may be permi ed in lieu of
bond. This policy does not require prior approval of the governing body.
Signed this ______ day of (month) _________________, 20____, by the undersigned
applicant.
______________________________________
Applicant
City of Galena, Kansas 211 W 7th Street, Galena, KS 66739 Phone: (620) 783-5265 FAX: (620) 783-5111
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Permit To Move Building 1 (City of Galena)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 14 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document