Single Family Residential Home Permit Application
Please fill out all of the information below. This application is for a SINGLE FAMILY RESIDENTIAL PERMIT in a platted subdivision. If the lot is not platted, please contact JCW at 913-715-8520 to request the permit. Please press the Submit button at the end to submit your application. You will be notified by e-mail when your application is processed. Thank you.

1. Owner Information
Owner Name:
Mailing Address:
City:
State:
Zip:
Email Address:
Phone Number:
2. Builder Information
Company Name:
If Owner and Builder Name and Address are the same, check this box.
Contact Name:
Mailing Address:
City:
State:
Zip:
Email Address:
Phone Number:
3. New Residential Permit Information
Permit Site Address:
Permit City:
Water Meter Size:
Permit Subdivision Name:
Permit Lot No:
Permit Block No: (As applicable)
Permit Plat No:
Plumber:
Plumber Contact:
Plumber Address:
Plumber Phone:
Pre-Paid Plug Procedure Requested:
Permit Type: