Building Permit Application Form - City Of Owen, Wisconsin
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1CITY OF OWEN
Building Permit Application
____ New Permit
____ Renewal Permit
____Late Renewal
____ After the Fact Permit
1. Is Zoning Approval Required? No__ *Yes __ *Approved by Zoning Adm. _______________________________________
(*Signature is required by Dennis Looker)
2. Is this a New Dwelling or an Addition? No__ *Yes__ *Must present Property Owner/Contractor State Packet for Bob Christenson
__________________________________________________
(*Signature is required by Applicant that packet was received)
3. Will this project (Dwelling) include Structural changes, Plumbing and/or Electrical Work? No__ *Yes__ *Must present Property
Owner/Contractor State Packet for Bob Christenson. __________________________________________________
(*Signature is required by Applicant that packet was received)
--------------------------------------------------------------------------------------------------------------------------- ---------------------------------------
4. Is this a New
Commercial
Bldg. or an Addition? No__ *Yes___ *Permits and Inspections are completed by State Inspectors &
copies are requested for the City along with a copy of the building plans.
Permit No. ___________
Date Issued __________
Permit Expires __________
Permit Applicant:
___________________________________________________________________
Last Name
First Name
Street Address
City
State
Zip Code
Telephone Number
Contractor:
___________________________________________________________________
Last Name
First Name
Street Address
City
State
Zip Code
Telephone Number
Project Physical Address: ________________________________________________________
City
State
Zip Code
____________________________________________________
Project Description:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
: $$ ___________________________________
Estimated Cost of Project
By signing this document applicant acknowledges that they have received a copy of the current
ordinance (Title 15, Chapters 1-8) dated 1/1/2012 regarding building permits.
Applicant’s Signature:
___________________________________________________
_________________
____________
Date:
Fees Paid:
New Permit/Renewal Permit $25.00
New Construction Permit $100.00
Late Renewal/After the Fact Permit-Cost is Doubled
______________________________________________________
Permit Issued By:
Please notify City Hall at (715) 229-2404 when your project is completed. Thank you!
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