PROJECT PERMITS
APPLICATION
All fields must be completed before permit will be processed.
Project Address
Parcel #
Project #
Property Owner
Contractor
Name Name
Company
(if applies)
Company
Address
Address
City, State, Zip
City, State, Zip
Phone #
Email
Phone #
Email
Current Land Use, Flood Plain & Zoning (check which applies)
Land Use: 2-Family Multi-Family # of units ____ Commercial (describe) _______________
Vacant Lot
1-Family
Zoning: R-1 R- 2 R-3 RR OR NC
D C-1 C-2 C-3 L1 G1 BP PI CON TND
Flood Plain: Yes
Base Flood Elevation (BFE)_____
No
Addition Alteration Repair Move Raze (demolish)
Change-of-use
Project Scope:
New
Area: Finished Unfinished Total Bldg:
Description of Project :
Estimated Cost of Construction $
Erosion Control # _________
City SBD $___________
Plan Approvals
PLBG Plan
SWR Plan
Foot & Found Only #_______ City
Building Plan
HVAC Plan
Site Plan
# _________ City SBD $___________
# _________ City SBD $___________
# _________ $___________
Contractors (UDC Numbers Required): DCC # DCQ #
BLDG -
Bldg Fee
ELEC –
Elec Fee
HVAC –
Hvac Fee
PLBG –________# of Fixtures
Plbg Fee
SWRS –
Water Fee $_____
Storm Fee $_____
Assessment $_____
Sanitary Fee $_____
Assessment $_____
Swrs Fee
CERTIFICATE OF OCCUPANCY
C.O.
$
Addl. Fee
Double Fee
DOUBLE FEE PERMIT [s.15.07(b)] If application for a building permit has not been obtained prior to commencement of
the job, applicable permit fee shall be doubled.
Application Signature The applicant certifies that information submitted herein is accurate; agrees to comply with the Wisconsin
Administrative Code, Municipal Ordinance, and with the conditions of this permit; and understands that permit issuance creates no legal
liability, expressed or implied, on the Department or Municipality.
Signature of Applicant Date
Class Code Census Receipt No. Total Fee
Reviewed By
Credential #
White - Office
Yellow - Applicant
To schedule an inspection, submit an online Inspection Request or call (920) 448-3300 at least one business day
in advance. Final inspections are required for all projects.
Department of Community
and Economic Development
100 N. Jefferson Street, Rm 608
Green Bay, WI 54301-5026
(920) 448-3300 - phone
(920) 448-3426 - fax
inspmail@greenbaywi.gov
www.greenbaywi.gov
(assigned by City)
$
$
$
Erosion Ctrl
EROSION CONTROL
ADDITIONAL PERMITS (Sprinklers #_____, Curb Cut, Flood Plain, Temp. Occupancy, Etc.)
(Please List)
(Rev 6/20)
(check all that apply)
Height
#_______
City
#_______ City
SBD $__________
SBD $__________
SBD $__________
For Office Use Only
click to sign
signature
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click to sign
signature
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