New Home Construction Packet_2025

BUILDING Permit No. PERMIT APPLICATION Parcel No. Town of Chase Project Description Building Address Owner's Name Mailing Address Tel. Contractor Name & Type Lie/Cert# Mailing Address Tel. &Fax Dwelling Contractor (Constr.) Dwelling Contr. Qualifier The Dwelling Contr. Qualifier shall be an owner, CEO, COB or employee of the Dwelling Contr. HVAC Electrical Plumbing PROJECT INFORMATION I Lot area Sq. ft. I Subdivision Name Lot No. Zoning District(s) I Zoning Permit I 0 One acre or I Setbacks: I Front ft. I Rear I Left No. more of soil will ft. be distrubed 1. PROJECT 3. OCCUPANCY 6. EL ECTRIC 10. HVAC EQUIP. 13. EN ERGY SOURCE Entrance Panel 0 Furnace FUEL Nat. Gas L.P. Oil □ New Repair 0 Single Family Amps: 0 Radiant Basebd □ Alteration Raze □ Two Family 0 Underground SPACE HTG. 0 0 0 0 Heat Pump □ Addition 0 Move 0 Garage 0 Overhead WATERHTG. 0 0 0 □ Other: 7. WALLS 0 Boiler ft. I Right ft. Elec. Solid Solar 0 0 0 0 0 □ Other: 0 Central AC 0 Dwelling unit bas 3 kilowan or more in electric space heating □ Wood Frame OJCF 0 Fireplace equipment capacity. 2. AREA IN VOLVED (Sq ft) 4. CONST. TYPE 0 Timber/Pole □ Other Uofin. Bsmt 0 Mfd. per WI UDC Other: 11. SEW ER Fin. Bsmt 0 Mfd. per US 8. FOUNDATION BTU/HR Total Calculated 0 Municipal Envelope and Infiltration Losses ("Maximum Allowable Living Area □HUD 0 Concrete Bonus Area 0 Masonry 0 Sanitary Permit# Heating Equipment Output'' on Energy Worksheet; 5. STORIES 0 Treated Wood "Total Building Heating Load" on Rescheck report) Garage 0 I-Story 0 Other: Deck 12.WATER 14. EST. BUILDING COST w/o LAND0 2- Story 9. USEOther $ 0 Other: 0 Seasonal 0 Municipal Totals 0 Permanent 0 On-Site Well □ Other: l 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 state or municipality; and certify that all the above information is accurate .. If one acre or more of soil will be disturbed, I understand that this project is subject to ch. NR 15 l regarding additional erosion control and storm water management and the owner shall sign the statement on the back of the permit if not signing below. l 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. 0 I vouch that I am or will be an owner-occupant of this dwelling for which I am applying for an erosion control or construction permit without a Dw elling Contractor Certification and have read the cautionary statement regarding contractor responsibility. APPLICANT'S SIGNATURE DATE SIGNED APPROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty. D See attached for conditions of approval. * GRADE & SETBACKS-RESPONSIBILITY OF OWNER/CONTRACTOR * ABIDING BY SUBDIVISION COVENANTS IS THE RESPONSIBILITY OF OWNER/CONTRACTOR FE ES: PERMJT(S) ISSUED WI S PERMIT SEAL# PERMIT ISSUED BY: Building Fee $ Zoning Fee $ 0 Construction MUNICIPALITY# Name Wis. Permit Seal $ □ HVAC Erosion Control $ 0 Electrical Date Tel. Escrow $ 0 Plumbing $ RECEIPT INFO 0 Erosion Control CK# Cert No. Other $ Total $ Date Rec. By: The information you provide may be used by other government agency programs [(Privacy Law, s. 15.04 (l )(m)]