City of Madison ePayment Center: Lake Access Permits

City of Madison Lake Access Permit:

Required Fields are in red BOLD and are identified by an asterisk (*)

*County:

*Birth Date: (MM/DD/YYYY)

*License Plate #
or Disabled #:

Description

Cost

Quantity

Total

Dane County Resident

$30.00

Non-Resident

$40.00

Non-Resident Senior

$22.00

Dane County Senior (65+)

$15.00

Disabled

$15.00

Replacement/2nd Vehicle

$12.00

Sub Total:

Shipping and Handling

$ 3.00: Standard Shipping

$18.00: Upgrade to Next Business Day Shipping

Shipping Option

Please send to a location other than my billing address

First Name:

MI:

Last Name:

Street Address:

City:

State:

Zip Code:

(12345)