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Project Address Suite # Applicant Address Applicant E-mail Applicant Phone Applicant Fax Property Owner (if different) Address Owner E-mail Owner Phone Owner Fax RESIDENTIAL COMMERCIAL INDUSTRIAL NEW Construction Type Start Date Est. Completion Date Setbacks Front: Side R. Side L. Rear Lot Coverage Estimated Building Cost $ Building Contractor WI Qualifier WI Contractor Phone SQUARE FOOTAGE 2ND FLOOR DECK PORCH GARAGE OTHER TOTAL Sq. FEES (OFFICIAL USE ONLY) BUILDING ELECTRIC PLUMBING HVAC FIRE SUPP. FIRE ALARM AA VALVE TOTAL Electrical Contractor WI Master Electrician License WI Electrical Contractor # Address Phone E-mail Address: Plumbing Contractor WI Master Plumber License Address Air Admittance Valve(s) x $50.00 Each = Phone E-mail Address: Suppression Contractor Contractor Address Phone # E-mail Address: Heating Contractor WI HVAC Contractor WI HVAC Qualifier Address Phone E-mail Address: Fire Alarm Contractor Contractor # Address Phone # E-mail Address: Description of Work: Date paid: Receipt # Total Permit Fee I agree to comply with all applicable codes, statutes and ordinances and with the conditions of this permit, understand that the issuance of the permit creates no legal liability, express or implied, on the city, and certify that all the above information is accurate. I expressly grant the building inspector, or the inspector’s authorized agent, permission to enter the premises for which this permit is sought at all reasonable hours and for any proper purpose to inspect the work which is being done. Signature of Applicant Date Print Name REQUIRED INSPECTIONS (WHERE APPLICABLE); FOOTING; FOUNDATION; VAPOR BARRIER; ROUGH; INSULATION; FINAL BUILDING PERMIT APPLICATION – NEW OR ADDITION CITY OF MIDDLETON 7426 HUBBARD AVE. MIDDLETON, WI 53562 608/821-8370; FAX: 608/827-1080 cityofmiddleton.us OFFICE USE ONLY PERMIT DATE ISSUED BASEMENT 1ST FLOOR ---PAGE BREAK--- G:\Data\DBases\Forms\Permit\Word\ZoningPermitApplication20170721.doc Revised 07/21/17) ZONING PERMIT CITY OF MIDDLETON · 7426 HUBBARD AVE. · MIDDLETON, WI 53562 PHONE (608) 821-8370 · FAX (608) 827-1080 · www.cityofmiddleton.us No structure shall be erected or altered without first obtaining a Zoning Permit pursuant to Section 10.127(1) of the City of Middleton Zoning Ordinance as well as the appropriate Building Permit(s). Zoning Permit Fees (pursuant to City of Middleton Code of Ordinances, Section 10.128(1)(g)): PROJECT CLASS PRINCIPAL STRUCTURE ADDITIONS (e.g. garage, deck) ACCESSORY STRUCTURES (e.g. shed, fence) One Family and Duplex $250 $50 $25 Multifamily $500 $250 $100 Small Commercial / Industrial (up to 20,000 SF) $500 $250 $100 Large Commercial / Industrial (over 20,000 SF) $1,000 $250 $100 NOTE: Only one fee is charged per application. If an application includes more than one structure type on the same lot, only the highest fee applies. SECTION 1 – APPLICATION (TO BE COMPLETED BY APPLICANT) INSTRUCTIONS: This application must be accompanied by a Site Plan that illustrates building dimensions and setbacks measured to foundation walls, with dimensions of roof eaves and other overhangs clearly indicated. Fence-only applications may contain less detail. Prior to plan submittal, applicant should identify lot boundaries and determine whether any public or private easements affect the property. Prior to construction, contact Digger’s Hotline at (800) 242-8511. Some properties in the city require the approval of a Neighborhood Architectural Review Committee or Homeowner’s Association that is separate from the City permitting process. ADDRESS OF PROPERTY WORK CONSISTS OF OWNER PROJECT REPRESENTATIVE (Contractor, Coordinator, Other) NAME CONTACT NAME BUSINESS NAME or CO-OWNER’S NAME (if applicable) BUSINESS NAME (if applicable) MAILING ADDRESS MAILING ADDRESS CITY, STATE, ZIP CITY, STATE, ZIP DAYTIME PHONE # DAYTIME PHONE # EMAIL EMAIL PROJECT CLASS (Check One) SINGLE FAMILY DUPLEX MULTIFAMILY SMALL COMMERCIAL / INDUSTRIAL (up to 20,000 SF) LARGE COMMERCIAL / INDUSTRIAL (over 20,000 SF) PROJECT SCOPE (Check all that apply) NEW STRUCTURE ADDITION ALTERATION STRUCTURE TYPE (Check all that apply) PRINCIPAL STRUCTURE GARAGE DECK SHED FENCE POOL OTHER SITE DATA (not required for fence-only applications LOT AREA (sq.ft.) IMPERVIOUS SURFACE AREAS EXISTING PLANNED CHANGES STRUCTURES (include roof eaves & other overhangs) SF SF DRIVEWAYS, PARKING AREAS, WALKWAYS SF SF OTHER FLAT SURFACES (patios, uncovered decks) SF SF I, the undersigned, do hereby certify that the above information is correct and agree that in the performance of this work I will be bound by and submit to all statutes of the State of Wisconsin, conform to all applicable codes and ordinances of the City of Middleton, and abide by all other applicable rules and regulations. Furthermore, I understand that the City of Middleton is not responsible for enforcing neighborhood covenants, and any granted zoning variances apply only for the specific structure(s) reviewed by the Zoning Board of Appeals. I understand that the City may remove any structure or landscaping feature placed within or upon a public utility easement, and that any repair or restoration work will be at property owner expense. SIGNATURE OF APPLICANT (must be owner or project representative listed above) DATE PERMIT Permit Fee: Fee Paid: □ Approved By: Approval Date: / / ---PAGE BREAK--- G:\Data\DBases\Forms\Permit\Word\ZoningPermitApplication20170721.doc Revised 07/21/17) SECTION 2 – STAFF REVIEW (PERTINENT SECTIONS TO BE COMPLETED BY PLANNING / ZONING OFFICIALS) ADDRESS REVIEWED BY: ZONING DISTRICT PDD NAME (if applicable) REVIEW DATE: PROPOSED USE / ACTIVITY IS PERMITTED IN ZONING DISTRICT YES NO REQUIRES CONDITIONAL USE PERMIT 100-YEAR FLOODPLAIN YES NO UNCLEAR LOT AREA (SF) CORNER LOT YES NO FEE CATEGORY PRINCIPAL ADDITION ACCESSORY ZONING REQUIREMENTS: MEASUREMENTS APPLY TO: EAVES WALLS unless indicated otherwise SETBACKS OF PRIMARY STRUCTURES ALLOWED BY CODE (in feet unless indicated otherwise) PLAN COMPLIES COMMENTS FRONT MIN. MAX. YES NO REAR MIN. MAX. YES NO LEFT YES NO RIGHT YES NO GARAGE DOOR WALL (if applicable) YES NO ARCHITECTURAL FEATURES MAY ENCROACH A CERTAIN DISTANCE YES NO YES NO MAX. BUILDING HEIGHT FEET STORIES YES NO ACCESSORY STRUCTURES (LIST, IF ANY) SETBACKS HEIGHT YES NO YES NO DRIVEWAY REGULATIONS WIDTH SETBACK YES NO MAX. LOT COVERAGE PERCENT AREA YES NO EAVES WALLS MAX. IMPERVIOUS SURFACE AREA PERCENT AREA YES NO EAVES WALLS FENCE REGULATIONS · Decorative side must face outward; fence side with posts must face inward. · No sharp edges or any materials that may pose a hazard or easily fall into disrepair. · Fence within 5 feet of rear and side lot lines limited to height of 6 feet, including posts. · Fence in front yard must be decorative, no taller than 3 ft., and ≥ 50% airspace. · Lakeshore lots have additional fence regulations. YES NO CONDITIONS OF APPROVAL 1. During construction, all lot corner monuments must be visible or indicated by stakes. 2. Compliance with conditions of approval stipulated by: Plan Commission minutes of Zoning Board of Appeals minutes of ---PAGE BREAK--- Building Permit # Date Issued: IMPACT FEES CITY OF MIDDLETON 7426 HUBBARD AVE. MIDDLETON, WI 53562 [PHONE REDACTED] FAX [PHONE REDACTED] www.cityofmiddleton.us On November 6, 2007, the Common Council approved the creation of City Ordinance section 3.11 establishing Public Impact Fees, pursuant to Wis. Stats. 66.0617. You may pay these fees at this time or within 14 days of the issuance of your Building Permit. ANY PERSON FAILING TO TIMELY PAY AN IMPACT FEE DUE IN FULL AFTER ISSUANCE OF A BUILDING PERMIT SHALL BE SUBJECT TO SUMMARY REVOCATION OF SAID BUILDING PERMIT THE DAY AFTER THE IMPACT FEE WAS DUE IN FULL. AMOUNT OF EXEMPTION for Low Cost Housing purposes: Public Facilities Needs Assessment and Impact Fee Impact Fee Single Family & Duplex (per DU) Multi-Family 2+ bedrooms (per DU) Multi-Family 1 bedroom (per DU) Commercial new or add. (per SF) Industrial new or add. (per SF) This Project Fire $238 $179 $119 $0.070 $0.050 $ EMS $260 $195 $130 $0.080 $0.050 $ Total $1,240 $930 $620 $0.380 $0.240 $ DU/SF SF & Duplex Project Address MF 2+ bedroom MF 1 bedroom Commercial Industrial Project Name and Description Applicant Address Phone Fax Landowner Address Phone Fax I certify that all information is correct and that all pertinent City Ordinances will be complied with in performing the work for this project. Signature of Applicant Date Print Name Date paid Receipt # Total Impact Fee $ ---PAGE BREAK--- BUILDING INSPECTION DEPARTMENT CITY OF MIDDLETON 7 426 HUBBARD A VENUE MIDDLETON, WI 53562-3118 PH [PHONE REDACTED] FAX [PHONE REDACTED] Email: [EMAIL REDACTED] WEB: www.cityofmiddleton.us INSPECTION CHECKLIST - BUILDING PERMIT# Subcontractors shall request inspections for their own work by contacting the BUILDING INSPECTION DEPARTMENT at 821-8370. Failure to give proper inspection notification may result in fines. The Building Permit Applicant (signature on application) is responsible to verify that all required inspections have been made. Any developer/contractor who calls for an inspection before the work is ready for inspection may be assessed a fine of fifty dollars ($50.00) per inspection. EROSION CONTROL INSPECTION to be completed prior to footing inspection. Perimeter erosion control measures shall be placed within 24 hrs after beginning excavation. FOOTING INSPECTION to be completed after f01ms and required reinforcing are in place, but before concrete is poured. FOUNDATION INSPECTION to be completed before backfilling. ROUGH INSPECTION to be completed for each category below before work is covered or concealed. UNDERGROUND/UNDERSLAB PLUMBING/ELECTRICAL/HVAC UNDER FLOOR VAPOR BARRIER (BASEMENT) BUILDING FRAMING ELECTRICAL PLUMBING HVAC INSULATION INSPECTION to be completed after insulation and vapor barrier are in place, but before they are covered or concealed. FINAL INSPECTION to be completed for each category below after all work is completed, but before use or occupancy. BUILDING ELECTRICAL PLUMBING HVAC Inspection results will be posted on the door jam of a bathroom (residential) or near the front door (commercial). Work shall not proceed until required inspections are completed and approval has been granted. If a required inspection is not completed within two working days after proper notification has been given, the contractor may proceed to the next phase of construction. THE MIDDLETON BUILDING CODE REQUIRES THAT A CERTIFICATE OF OCCUPANCY BE ISSUED BY THE BUILDING INSPECTOR PRIOR TO THE OCCUPANCY OR USE OF THE BUILDING. THIS ALSO COVERS USING A BUILDING FOR STORAGE OR MOVING ITEMS INTO THE BUILDING.