City of Leon Landlord Permit Application

CITY OF LEON, KANSAS - LANDLORD PERMIT APPLICATION

Complete all landlord, property, eligibility, utility-notice, and certification sections, then provide your electronic signature and date.
Application and Landlord Information
Date of Application

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Landlord / Applicant Full Legal Name

First NameMiddle NameLast Name
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City
State
ZIP Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Preferred Contact Method
Emergency Contact Name

First NameMiddle NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Management and Ownership
Is an authorized manager or agent used?
Manager or agent name

First NameMiddle NameLast Name
Manager or agent mailing address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Manager or agent phone
Please enter a valid phone number.Format: (000) 000-0000.
Manager or agent email
example@example.com
Proof of authority

Cancelof
Ownership structure
Legal entity name
Is any rental owned wholly or partly by a corporation?
Kansas business/entity registration or good-standing documentation (if applicable)

Cancelof
Rental Properties

Tenant names are not routinely required in this section and may be requested separately only when authorized by applicable Kansas law or through the City’s separate utility or occupancy processes.
Property Entry
Street Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parcel ID (if known)
Rental Type
Number of Units
Occupant/Tenant Names
Occupancy Status
Eligibility
Have you, your partner, or any corporate officer ever been denied a landlord license, or had one revoked or suspended?
If yes, please explain the denial, revocation, or suspension.
Has any owner or corporate officer ever been convicted of a felony related to maintaining or conducting a business or commercial activity?
Certification: I certify that this application is accurate, complete, and contains no material omissions or materially false or misleading information.
Utilities and Notices
Acknowledge that owners and occupants are jointly responsible for City utility charges
Vacancy option for water, sewer, and trash service
Acknowledge tenant-transfer paperwork, City notices, and utility delinquency notices
Acknowledge duty to keep City contact, ownership, management, occupancy, and vacancy information current
Landlord Certifications
1. I agree to prevent and abate nuisances, including nuisances caused by tenants, as required by the City of Leon. Enter your initials or signature for this statement.
I agree to cooperate with inspections authorized by applicable law and City Code. Interior inspections of occupied residential property will be handled in accordance with Kansas law and any required occupant consent, warrant, or other lawful authority.
3. I understand that I must reapply annually and update my information as required by the City of Leon. Enter your initials or signature for this statement.
4. I understand that the permit may apply only to the rental property or properties listed in this application. Enter your initials or signature for this statement.
5. I understand that the permit may be revoked for noncompliance with City requirements. Enter your initials or signature for this statement.
6. I agree to pay the annual permit fee of $250 after a Notice and Order is issued, as applicable. Enter your initials or signature for this statement.
7. I understand that the permit fee is all-inclusive and is my responsibility unless otherwise approved by the City. Enter your initials or signature for this statement.
8. I understand that failure to pay required fees may result in enforcement action or permit-related consequences. Enter your initials or signature for this statement.
9. I certify that the information provided in this application is accurate and complete to the best of my knowledge. Enter your initials or signature for this statement.
10. I understand that any joint utility liability associated with the rental property remains my responsibility unless otherwise arranged with the utility provider. Enter your initials or signature for this statement.
11. I understand that notice delivery may be made by the City using the contact information provided in this application. Enter your initials or signature for this statement.
12. I understand that utility service disconnection timing may occur according to applicable utility procedures and City requirements. Enter your initials or signature for this statement.
13. I agree to keep my contact information current and to notify the City of any required updates. Enter your initials or signature for this statement.
14. I understand that utility transfer paperwork must be completed when required for occupancy changes or property transactions. Enter your initials or signature for this statement.
15. When a rental unit becomes vacant, select the service action to be taken. Enter your initials or signature for this statement.

Other
Documents and Final Signature
Ownership/Management Authority Document

Cancelof
Kansas Good-Standing Certificate (if applicable)

Cancelof
Additional Supporting Documents

Cancelof
Landlord Electronic Signature
City Use Only
Date Received

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Permit Fee
Payment Status
Council Approval Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Clerk Signature
Permit Number
Approval Status
Conditions / Staff Notes
Should be Empty:

CITY OF LEON, KANSAS - LANDLORD PERMIT APPLICATION

Application and Landlord Information

Management and Ownership

Rental Properties

Eligibility

Utilities and Notices

Landlord Certifications

Documents and Final Signature

City Use Only