Conditional Use Permit

Conditional Use Permit Application
Applicant/Agent Information
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Phone Number with Area CodeFormat: (000) 000-0000.
Email
example@example.com
Contact Person
Owner Information
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
Phone Number with Area CodeFormat: (000) 000-0000.
Email
example@example.com
Contact Person
Proposed Use Information
Present Zoning District
Present Land Use
Proposed Land Use
Reasons for Requesting Conditional Use Permit
Property Information
Legal Description
Address of Property
Site Size
Property Real Estate Number
Present Improvements or Structures
I, the undersigned am the (circle one) owner, duly authorized agent, of the aforementioned property situated in the unincorporated portion of Johnson County, Kansas. By execution of my signature, I do hereby Officially apply for a Conditional Use Permit as indicated above.
Signature
If you can’t sign above, please type your name in this box. It will serve as your digital signature.
Date
Should be Empty:

Conditional Use Permit Application