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
.
I
acknowledge I have received a copy of Wisconsin State Statute §823.08, known as
the Wisconsin Right to Farm State Statute.
Signed__________________________________________ Date______________________
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TOWN OF ANGELICA BUILDING PERMIT ---
PERMIT NUMBER ________
This
certifies that ________________________ ________________________________________
(Name)
(Address of Construction Project)
has been issued a Town of Angelica Building Permit 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
6-8-09