SHORT FORM for all projects other than a new dwelling.

Send application & fee to:  Tom Smith Inspections - 2740 Otto Ct. - Green Bay WI 54313

Project will be built in what municipality? ______________________________________________________          Date _____________


Street address for  project:________________________________________

                           Parcel Number:  ____________________________________        Estimated project cost  _____________________ (Do not include cost of land.)

                                                                                                                                   County Land Use / Zoning permit when required.

Owner:  (Print clearly)__________________________________________                 _________________________________________________

Owner Address:_______________________________________________                    WHERE DO YOU WANT ME  TO SEND PERMIT CARD ?

               _______________________________________________                          _________________________________________________

Phone: or email:   ______________________________________________                          _________________________________________________

                                                                                                                                                                               ________________ _________________________________

(Provide names of contractors that will be doing work on this project.)

General Contractor:  ________________________________________ _______________________________Phone ____________________

Electrical Contractor________________________________________________________________________Phone ____________________

Plumbing Contractor  _______________________________________ _______________________________Phone ____________________

HVAC Contractor  ________________________________________ _______________________________Phone ____________________


( Check all that apply for your project and this permit request. )

                 Standards of the Wisconsin UDC Building Codes and National Electrical or Fuel codes will be used to inspect quality of construction.

____Building detached accessory building  - Width ___ Length ___ Height ___

____ Building bathroom or sleeping loft.

____Addition to an existing building - Width ___Length ___

____Barn for livestock or fowl  - Width ___Length ___

____ Egress windows from below grade. ( Click here for more information)

____ Finish garage or basement  into living space. _____ sq ft

____ Electric service upgrade by __WPS ___OEC ___WE ___Kaukauna Utility

____ Deck  ( See note below)    - Width ___   Length ___

____Fence   - How many feet?  ________

____ Roadside stand not removed daily.  Width   _____ Length _____

____ Above ground pool.     ______  In ground pool.

____ New commercial antennas

____Re-roof         ______% being done

____Re-siding      ______% being done

____ Remodel  _______sq. ft..

____ Outdoor boiler

____ Permit to raze a structure.

____ Other __________________________________________________

                        __________________________________________________

Please provide a site plan  showing where new buildings  will be placed on lot.  Does not need to be to scale but indicate set backs and other distance measurements between structures on drawing.  Information on minimum setback distances available on my website. Click here for LINK.


Deck building information available at this link  https://dsps.wi.gov/Documents/Programs/UDC/DeckColumnFootingSizeWorksheet.pdf

Prevent erosion on your construction site:

 Sediment control practices shall be employed as necessary and maintained to prevent or reduce the potential deposition of soil or sediment into the waters of the state or adjacent properties.   Erosion control practices must be maintained until the disturbed areas are stabilized by the re-establishment of 70% of new vegetation.  

If more than one acre of land is disturbed the owner must get a formal approved plan from the Wis DNR. NOTE:    One acre is 43,560 square feet.

Go to following for more information : S.NR 151.32 (2).