Fillable Sewer: Deferred or Non-Deferred (circle one) Water: Deferred (City of Spring Hill)

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Sewer: Deferred or Non-Deferred (circle one) Water: Deferred (City of Spring Hill)

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Y:\City Hall\Community Development\FORMS\PERMIT APPS & HANDOUTS\NSF HOME - Building Permit Package\2020 Building Requirement Revision\New Const Permit App.doc
Revised 12.13.19
To the City of Spring Hill, Kansas:
The undersigned is the owner – duly authorized agent – contractor of the owner of the following described real property:
Property Address: Lot No. Block No.
Subdivision: Phase/Plat: County: Johnson Miami
Type of Zoning (Residential Projects): R-1 RP-1 R-2 RP-2 R-3 RP-3 R-4 RP-4
Type of Zoning (Commercial Projects): C-O C-1 C-2 CP-2 MP M-1
Type of Building Permit: New Construction Remodel/Restoration Residential Addition
Plan Name (for new construction only): _________________________________________________________________________________
General description of building or structure (i.e. NSF home, basement finish):
Please indicate the square footage for the following:
FLOOR AREA: 1
st
floor 2
nd
floor GARAGE: DECK:
FINISHED BASEMENT: UNFINISHED BASEMENT: OTHER (brief description)
VALUATION OF PROJECT: $
NEW Construction Formula – approx. selling price of house, minus cost of lot, minus sewer/water connection fee
OTHER Construction Formula – approx. cost of project (labor & materials)
Contractor Information
Company Name:
Contact Name: Check One: Owner Agent Contractor
Address: City State Zip
Phone: Email:
License # & Jurisdiction:
Mechanical Contractor Electrical Contractor
Company Name: Company Name:
Address: Address:
Phone: Phone:
License # & Jurisdiction: License # & Jurisdiction:
Plumbing Contractor Framing Contractor
Company Name: Company Name:
Address: Address:
Phone: Phone:
License # & Jurisdiction: License # & Jurisdiction:
I affirm that the information provided is true and correct, and I agree to conform to all regulations of the City of Spring Hill covering this type of work. I state that the
work done is performed by the licensed contractor as outlined above. I understand failure to comply with these provisions may result in the revocation of this permit
and/or contractor license.
Applicant Name (print) Applicant Signature
Phone E-mail Date
Please refer to the Building Requirements Checklist for details regarding the application submittal process.
New Construction Application
Community Development/Planning Dept.
401 N. Madison St., Spring Hill, KS 66083
(913) 592-3657 ● (913) 592-5040 FAX
planning@springhillks.gov ● www.springhillks.gov
OFFICE USE ONLY
Building Permit:
Authorized by: Date: __
Permit Fee (including Plan Review Fees) $ __________
Sewer: Deferred or Non-Deferred (circle one)
Water: Deferred or Non-Deferred (circle one)
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Sewer: Deferred or Non-Deferred (circle one) Water: Deferred (City of Spring Hill)

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Completed 16 July 2020

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