APPLICATION FOR TOWN OF ANGELICA BUILDING PERMIT  ~ (Pursuant to Town of Angelica Ordinance 1-9-95A)

 

 

Name of Applicant________________________________________________________________

 

Address________________________________________________________________________

 

Phone Number___(______)_______________________

 

Address/911 Number of Construction Project  ___________________________________________

 

Phone Number at Construction Project (if available)____(_______)____________________________

 

Date Driveway/Culvert Permit obtained________________ Permit Number:_________________

Date Sanitary Permit obtained_______________________ Permit Number:__________________

 

Type of Building Permit:

  ___ One and two family dwelling, manufactured home or attached unit...specify:___________________

  ___ Addition or improvement to existing structure...specify:____________________________________

  ___ Other structure...specify:____________________________________________________________

 

Anticipated Commencement Date__________ Anticipated Time Length to Complete Project__________

Estimated Cost of Project  $________________________

 

Dimensions:_______________________________________________________________________

Provide sketch of home foundation dimensions.  If home has an attached garage, show dimensions of living area separate from garage dimensions .

 

                Signed__________________________________________   Date______________________

 

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TOWN OF ANGELICA BUILDING PERMIT  ---   PERMIT NUMBER ________

 

This certifies that  ____________________      ___________________________________

                                   (Name)                                                      (Address of Construction Project)

 

has been issued Permit Number _____________ for the construction or moving of:

 

    ____ New Building Structure_______________________________________________________

    ____ Addition to Existing Structure___________________________________________________

    ____ Installation of Manufactured Home or Building____­__________________________________

    ____ Electrical Construction________________________________________________________

 

FEE: ____ $10.00........$50,000.00 or under in value         _____  $20.00...under $50,000.00 in value after-the-fact

         ____  $25.00......... over $50,0000.00 in value              _____  $50.00.....over $50,000.00 in value after-the-fact

This permit shall be effective for one year from the issuance date.  The permit may be renewed for an additional six months at half the initial annual permit rate.

                                                                                   

              __________________________________________        ___________________________

                             Town of Angelica Issuer                                                      Date Issued

1-29-07

 

 

 

 

 

 

CONTACT:        Town of Angelica Issuer ~             Janet Powers, Town of Angelica Clerk

                                                                                   W1569 County Road C, Pulaski  WI  54162

                                                                                   Phone:  (920) 822-5554