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Building Permit # Date Issued: PC File g:\data\dbases\forms\gen\word\gis fee 2014-02-18.doc 1 of 2 07/01/2015 GIS FEES CITY OF MIDDLETON [PHONE REDACTED] 7426 HUBBARD AVE fax [PHONE REDACTED] MIDDLETON, WI 53562 www.cityofmiddleton.us On December 4, 2012 , the Common Council approved the creation of a City Ordinance es tablishing GIS Fees, to recover costs of record updates as a result of land divisions. Section 3.12 of the City of Middleton Code of Ordinances relating to the fees charged under Section 19.04(7)(b) states as follows: Fees to defray administrative expenses – $500.00 plus $30.00 per lot GIS and records update, Plats Fees to defray administrative expenses – $200.00 plus $30.00 per lot GIS and records update, CSM Fees to defray administrative expenses - $0.75 x total pipe length the total footage of GIS and records update, Public Improvements all public pipes plus private storm water conveyances This Project: Plat: lots x $30/lot + $500.00 = CSM: lots x $30/lot + $200.00 = Public Improvements: linear feet of public pipes x $0.75/lf = linear feet of private storm water conveyances x $0.75/lf = TOTAL GIS FEE: Project Address Project Name and Description Landowner Name Address Phone/Fax Applicant Address Phone/Fax ---PAGE BREAK--- Building Permit # Date Issued: PC File g:\data\dbases\forms\gen\word\gis fee 2014-02-18.doc 2 of 2 07/01/2015 Signature of Applicant Date Date paid Receipt # Total GIS Fee Paid $