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Wisconsin Uniform Building Permit Application

Wisconsin Division of Safety and BuildingsWisconsin Uniform Building Permit Application Application Stats. , Instructions on back of second ply. The information you provide may be used by other government agency programs [(Privacy Law, s. (1)(m)]Parcel REQUESTED Constr. HVAC Electric Plumbing Erosion Control Other: Owner s Name Mailing Address Tel. Contractor Name & Type Lic/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.)

(Part of Ply 4 for Applicants) Cautionary Statement to Owners Obtaining Building Permits 101.65(lr) of the Wisconsin Statutes requires municipalities that enforce the Uniform Dwelling Code to

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