County of Sauk
Town of Woodland
Application for Building Permit For use by Principal Authority Application number: Application Fee Received by______________ Date received: Amount $50.00 Non-Refundable
A. Project Location
________1/4 ________1/4 Section_____ T_____ R______
Project estimated value
$_______________________
B. Applicant Applicant is: ❑ Owner or ❑ Authorized agent of owner
Last name
First name
Street address
Unit number
Lot/con.
Postal code
E-mail
Telephone number ( )
Fax ( )
Cell number ( ) C. Owner (if different from applicant)
Last name
First name
Corporation or partnership
Street address
Unit number
Lot/con.
Municipality
Postal code
Province
E-mail
Telephone number ( )
Fax ( )
Cell number ( ) D. Builder (optional)
Last name
First name
Corporation or partnership (if applicable)
Street address
Municipality
Postal code
Lic/Cert #
E-mail
Telephone number ( )
Fax ( )
Cell number ( ) E. Purpose of application
❑ New construction
❑ Addition to an existing building
❑ Alteration/repair
❑ Demolition
❑ Conditional Permit
Proposed use of building
Current use of building
Description of proposed work
F. Town of Woodland Siting Ordinance
i. I have read the Town of Woodland Siting Ordinance attached to this application
❑ Yes
❑ No
ii. I understand that this application must be submitted 30 days prior to the regular monthly Plan Commission meeting. (2nd Monday of every month at 6:30 P.M)
❑ Yes
❑ No
iii. See attached fee schedule G. Attachments
i. Attach ALL required State and County permits (if applicable).
ii. Attach types and quantities of plans and specifications for the proposed construction or demolition that are prescribed by the Town of Woodland Siting Ordinance (copy attached) H. Declaration of applicant
I __________________________________________________________________________________________certify that: (print name)
1. The information contained in this application, attached schedules, attached plans and specifications, and other attached documentation is true to the best of my knowledge.
.
___________________________ _________________________________________________________________
Date Signature of applicant