Tract Lot Split Application
Ownership Information
Tract 1
Name
*
Address
*
City/State/Zip
*
Phone
*
Phone Number with Area Code
Format: (000) 000-0000.
Email
*
example@example.com
Contact Person
*
Tract 2
Name
*
Address
*
City/State/Zip
*
Phone
*
Phone Number with Area Code
Format: (000) 000-0000.
Email
*
example@example.com
Contact Person
*
Proposed Site Address
Tract 1
*
Tract 2
*
Proposed Acreage
Tract 1
*
Tract 2
*
I, the undersigned, am the (choose 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 Tract/Lot Split as indicated above.
*
Owner
Duly Authorized Agent
Signature, Owner of Tract 1
*
If you can’t sign above, please type your name in this box. It will serve as your digital signature.
*
Date
*
Signature, Owner of Tract 2
*
If you can’t sign above, please type your name in this box. It will serve as your digital signature.
*
Date
*
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