CARBON COUNTY Department of Planning and Development Application Fee $: 215 West Buffalo, Suite 336 Check #: Rawlins, WY 82301 Receipt #: Tel (307) 328-2651 FAX (307) 328-2735 Permit #: Date Issued: www.carbonwy.com APPLICATION FOR A BUILDING PERMIT (To be completed by applicant) (Please Print or Type) Applicant Mailing Address Date Phone Record Owner/Land Owner/Property Owner (if not Applicant) Mailing Address Phone Rural Address of the site (if available**) **If you do not have a physical rural address, please contact the Planning Department. Contractor &/or Architect Mailing Address Phone Value of Improvements $ LEGAL DESCRIPTION OF PROPERTY: Quarter Sections Section Township Range Subdivision Name Block # Lot # If the subject property is located in an approved subdivision, check to determine if there are private covenants and\or restrictions: YES NO DISCLAIMER: Carbon County has not reviewed this application to determine the applicability of any existing private covenants for the subject property. It is the applicant s and\or property owner s sole responsibility to maintain compliance with applicable private covenants and restrictions. Approximate location of proposed project and Road Name PRIMARY USE OF PROPERTY: Agriculture Mining Residential Recreational Commercial Industrial PROPOSED USE OF STRUCTURE: Agriculture Mining Residential Recreational Commercial Industrial Other (Please Specify) Lot Size or Acreage for the Proposed Project Project Description Total Square Footage 1 st floor 2 nd floor Building or Structure Height (measuring from ground to the highest peak of structure). There are height limitations depending on the zoning classification. Page -1-
If moving a factory built home on the property, please indicate the building code certifying construction. If questions or concerns, please contact your sales representative. The home is H.U.D. code certified (Housing and Urban Development) The home is I.R.C. certified (International Residential Code) The home is I.B.C. certified (International Building Code) NOTE TO APPLICANT: If any of the following items are applicable and missing, your application will not be processed or approved until it is determined to be complete. Please attach the following to this application: 1. Proof of Ownership (Recorded Warranty Deed, including the legal description of the property): a. Contract for Deed, or b. Quit Claim Deed, or c. Lease Agreement. 2. Site plan/map/plot (See attached Example Site Plan). 3. Application fee. 4. The applicant shall provide proof of valid, legal and useable access to the property from a public highway, road or street. 5. WY DEQ Septic/Wastewater Permit(s) (if applicable). Permit # Date Issued: (Attach copies of permit(s).) 6. WY State Engineer s Office Well Water Permit(s) (if applicable). Permit # Date Issued: (Attach copies of permits(s).) 7. State Fire Marshall s Office Permit(s) (if applicable). Permit # Date Issued: (Attach copies of permits(s).) MET TOWERS, WIND TURBINE GENERATORS, TELECOMMUNICATION TOWERS, TRANSMISSION LINES OR OTHER TOWERS: If the application is to modify an approved existing telecommunication tower, the land owner s signature is not required, when a valid land lease agreement is submitted with the application. 8. The applicant will provide a copy of the FAA determination of no-hazard to air navigation to the Carbon County Planning & Development Department along with any application for the siting and construction of a MET Tower. FAA Website Address: https://oeaaa.faa.gov/oeaaa/external/gistools/gisaction.jsp?action=shownonoticerequiredto olform 9. The applicant will provide a copy of the Wyoming Department of Transportation (WYDOT) Wyoming Meteorological Towers Reporting System form to the Carbon County Planning & Development Department along with any application for the siting and construction of a MET Tower. Website: https://wgfd.wyo.gov/mettowers/default.aspx 10. Structure location (required for communications towers, wind turbines, transmission lines MET Towers or other as requested): Tower Structure Height Elevation Latitude (Y) Longitude (X) OPTIONAL INFORMATION THAT MAY EXPEDIATE REVIEW. 1. If the Property is not adjacent to a public road, include a copy of the easement granting legal access to the property and any other easements on or serving the subject property. 2. Site Survey, Record of Survey, or Plat. 3. Parcel Identification Number (14 digit code)/current Tax Assessment Notice. 4. Zone District/Classification. Page -2-
I, the undersigned, fully understand and agree to abide by the rules and regulations as outlined in the Carbon County Zoning Resolution of 2015; and, agree to provide for this development an adequate water supply facility & sewage disposal system which meet the standards and requirements of the Wyoming State Health Department, the State Engineer s Office and the Wyoming Department of Environmental Quality; as well as, the development requirements outlined above. Furthermore, I understand that failure to comply with any of the above stated requirements represents a violation of the Carbon County Zoning Resolution of 2015, and subjects me to penalties, fines and damages as described in said resolution. The application shall be signed by the record land owner or the applicant may submit the owner s authorization in the form of an affidavit signed by the record owner, power of attorney or similar legal authorization. Applicant s Signature: Record Land Owner/Property Owner s Signature (if not applicant): PRINT YOUR SIGNATURE PRINT YOUR SIGNATURE APPLICAN TS SIGNATURE LANDOWNER S SIGNATURE DIRECT CONTACT PHONE NUMBER DIRECT CONTACT PHONE NUMBER DATE DATE ATTACHMENTS: Example Site Plan and Instructions Current Fee Schedule Notice: In accordance with Wyo. State Statutes 35-9-120; The installation of electrical equipment in or on buildings, mobile homes and premises shall be made subject to the applicable minimum requirements of the National Electrical Code. An electrical permit is required for new construction or remodeling if the remodeling requires a public utility to connect or disconnect and restore electrical power, of a building, mobile home or premises. For more information, please contact your licensed electrician, contractor, or the Wyoming Department of Fire Prevention and Electrical Safety in Cheyenne at 307-777-7288 or in Riverton at 307-856-7288 or visit their website: www.wyofire.state.wy.us. Date Revised: February 1, 2018 Page -3-
NAME/PROJECT SCALE: (SELECT ONE) 1 Sq = 5', 1 Sq = 10', 1 Sq = 20', OTHER USE THIS SHEET TO PREPARE SITE PLAN
CARBON COUNTY www.carbonwy.com PLANNING AND DEVELOPMENT TEL (307) 328-2651 FAX (307)328-2735 FEE SCHEDULE Please make checks payable to Carbon County Planning. Application Fee and Subdivision Permit Fees must be paid at the time the application is submitted and is not refundable. The newspaper(s) will bill the applicant directly for Public Notice charges. APPLICATION TYPES: FEES: Plus the cost of public notice. Conditional Use Permit (Minor) $200.00 Conditional Use Permit (Major) See Page 2 Conditional Use Permit Transfers $200.00 Zone Change $200.00 Planned Unit Development ZC $350.00 Planned Unit Development SUB Application fees in accordance with the Subdivision Subdivision Application/Filing Fees: Minor Subdivision Major Subdivision: Sketch Plan Preliminary Plat Application/Filing Fees below. Due upon submittal of the Application. $200.00 (Final Plat) $100.00 $200.00 + $100 per lot, up to $1,000.00 $200.00 Final Plat Subdivision Permit Fee The greater of $100.00 or $10.00 per lot up to $1,000.00 Variance $200.00 Sign, Floodplain and Solar Access $60.00 BUILDING PERMIT APPLICATION, INCLUDES ZONING CERTIFICATES: *VALUE OF IMPROVEMENTS OR REPLACEMENT COST NEW: APPLICATION FEE: $0.00 TO $5,000.00 $25.00 $5,001.00 TO $20,000.00 $75.00 $20,001.00 TO $100,000.00 $125.00 $100,001.00 TO $200,000.00 $150.00 $200,001.00 TO $300,000.00 $250.00 $300,001.00 TO $400,000.00 $350.00 $400,001.00 TO $500,000.00 $450.00 $500,001.00 TO $600,000.00 $550.00 $600,001.00 TO $700,000.00 $650.00 $700,001.00 TO $800,000.00 $750.00 $800,001.00 TO $900,000.00 $850.00 $900,001.00 TO $1,000,000.00 $950.00 $1,000,001.00 and over $1,150.00 Non-Commercial Wind Energy Generators, in accordance with above. *The cost including material and labor that will be incurred in constructing the improvement. Includes hired or contract labor but does not include owner/builder labor.
Number of Project Structures- Wind Turbines: OTHER BUILDING PERMIT APPLICATION FEES: Commercial Wind Energy Facilities - Each Wind Turbine - $175.00 Re-tooling\Reconstruction of Existing Facilities - Each Wind Turbine - $175.00 Transmission Line Towers or Poles - Each Tower or Pole - $175.00 Telecommunication and MET Towers - Each Tower or Pole - $350.00 Major Conditional Use Permit Applications: Commercial Wind Energy Facilities Transmission Lines over 115,000KV Application Fee: $100.00** Plus Number of Project Structures- Transmission Towers or Poles: Application Fee: $100.00** Plus 1-199 $3,000.00 1-199 $3,000.00 200-299 $4,000.00 200-299 $4,000.00 300-499 $5,000.00 300-499 $5,000.00 500-699 $7,000.00 500-699 $7,000.00 700-899 $9,000.00 700-899 $9,000.00 900 and over $10,000.00 900 and over $10,000.00 Not to exceed $10,100.00 **Plus the actual cost of public notice charges. PUBLICATIONS: available on-line: www.carbonwy.com Free Carbon County Zoning Resolution $25.00* Carbon County Subdivision Regulations $25.00* Carbon County Land Use Plan $50.00* *=Plus applicable postage charges. GIS Data and Maps: Custom Maps: $31.00 per hour (1 hour minimum) Parcel Data Shapefile: $400.00 (entire County) Parcel Data Update: $150.00 Other GIS Data: $20.00 per shapefile Road Data: $150.00 Address Points: $25.00 Employee time for assistance with preparing a complete application may be charged as per Resolution for professional time 1 hour minimum. Date Adopted: January 16, 2018 Page -2-