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Plumbing Permit Application
Project Address
Suite or Unit
Project Type
Permit Description
Application Information
Plumbing Contractor*
Plumbing Contractor Address
Phone
Plumbing Contractor E-mail Address
Wisconsin Plumbing License #
Expiration Date
Property Owner
Property Owner Address
Phone
Property Owner E-mail Address
New Building
Existing Building
Note: Water fixtures above elevation 998.0 will not be allowed unless Owner installs private booster pump to increase in-house pressure.
Inch Water Service from Property Line to Building
Inch Sewer Lateral from Property Line to Building
Inch Water Service to Property Line
Inch Sewer Lateral to Property Line
WATER CALCULATIONS
The City of Middleton requires Bacteria Samples for water services about 2", including distribution piping.
#DFU'S
# OF FIXTURES
Auto Wash
Back Water Valve
Bar Waste
Bath Tub
Catch Basin
Cellar Drain
Dishwasher
Disposal
Down Spouts
Drinking Fountain
Floor Drain
Gas (Testing Required) - RES.
Gas (Testing Required) - COMM.
Gas (Testing Required) - 2#
Gas (Testing Required) - 4#
Dryer
Fireplace
Stove
Grease Trap (State Approval Required)
Laundry
Machine Waste
Open Site for HVAC
Press. Reducing Valve (80LB. Max)
Ro Systems
Shower
Sill Cocks
Sinks (All Sinks)
Softener
Storm Sewer
Sump Pump
Urinal
Water Closet
Water Heater
CONNECTION FEES
Water
Meter Couplings
San Sewer Under 100'
San Sewer Over 100'
Storm Sewer Under 100'
Storm Sewer Over 100'
Sprinkler (Lawn)
Fixtures
Air Admit Valve
Remarks
The applicant certifies that all information is correct and that all pertinent City Ordinances will be complied with in performing the work for which this permit is issued.
Print Name
Date
A City of Middleton representative will contact you to request the balance of the information required to process this permit.
Please note that the contractor code is required.
Enter Contractor Code  Get Code