HomeMy WebLinkAbout0108495-Building (foundation)Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations
Safety and Buildings Division BUILDING PERMIT 0108495
P.O. Box 2509
. - APPLICATION Parcel NO.
Madison, WI 53701-2509
Wisconsin Statues 101.63, 101.73
[] Constr [] HVAC [] Bec [] Plbg [] Erosion [] Other:
Owner's Name Mailing Address Telephone No.
DONALD GREGORY DOBBERKE 3203 MARSH CREEK RD Oshkosh WI 54901 - 0000
Contractor: ~ Con[] Elec~ HVAC L~ Plbg Lic/Cert # Mailing Address Telephone No.
OWNER Oshkosh WI 54901 - 0
Contractor: [~ Con ~ Bec [~ HVACu Plbg Lic/Ce~ # Mailing Address Telephone No.
0 -0
Contractor: [~ Con L~ Elec~ HVAC ~j PIb~c Lic/Cert # Mailing Address Telephone No.
0 -0
Contractor: ~ Con ~ Elec[~ HVAC L~ PIbg Lic/Cert # Mailing Address Telephone No.
0 -0
Lot Area Sq. ff. 1/4, 1/4,Section ,T N,R E(or)W
Building Address Subdivision Name Lot No. Block No.
4505 CEDARVIEW DR
Zoning District(s) Zoning Permit No. Front I Rear Left Right
Setbacks ffI fl
[~J New [] Repair v'~ Single Family Entrance Panel ¢~ Forced Air Furnace Fuel Net bP. Oil Elec Solid Sola
~ Two Family Size: 200am ~ Radiant Baseboard or Panel Ga!
[][] AdditionAIterati°n [] Raze ~ Garage Service: ~ Heat Pump Space Htg [] [] [] [] [] []
[] Move ~ Other (print): [] Overhead ~ Boiler ! Water Htg [] [] [] [] [] []
[] Other: [] Underground ~ Central Air Conditioning * bJ Dwelling unit will have 3 kilowatt or
more installed electric space heating equip.
[] Site Constructed ~d Concrete Infiltration control option is: [] Full sealing
Unfinished [] Manufactured ~ Masonry 3ewer of joints. [] Blowerdcor test. [] Exterior
~ Treated Wood ,
Basement 0 Sq. ft. ~ Other i[] Municipal air infiltration barder.
1 -Story
Living Area 0 Sq ft. ~___' [] Septic
2-Story
Permit No. Envelope 28455 BTU/HR
Garage 0 Sq. ft. [] Other [] Seasonal Infiltration 22734 BTU/HR
[] Permanent [] Municipal Utility
[] Plus Basement [] Other [] Private On-Site Well $142,000.00
The applicant agrees to comply with all applicable codes, statues and ordinances and with the conditions of this permit, understands that the issuance of
the permit creates no legal liability, express.~,implied, on/th~,~)e~partment or municipality; and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE .'//~ ¢/1~,~d~'- DATE SIGNED
APPROVAL CONDITIONS This ~ermit is issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalty
see standard conditions of approval
[] Town [] Village [] City [] County bJ State of: Municipality Number of Dwelling Location:
City Of Oshkosh -
Plan Review $75.00 ¢~ Construction
~ HVAC Name Nicole Krahn
Inspection ~ Electrical
Wis. Permit Seal $30.00 [] Plumbing Date 4/19/04
Other [] Erosion
Total $105.00 [] 306886 Cert. No. 248101
SBD-5823 (R. 07/92)
OSHKOSH
ON THE WATER
Job Address
Name
Address
Subdivision
Building Permit Number
Number of Dwelling Units
Fee Required
PARKLAND DEDICATION FEE COLLECTION RECORD
4505 CEDARVIEW DR
DONALD GREGORY DOBBERKE
3203 MARSH CREEK RD
0108495
1
$200.00
Date 06/04/2004
Oshkosh WI 54901
Lot
Number of Structures
Fee Paid
Owner's Signature
Inspector's Signature
Date
Date