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CITY OF OSHKOSH N� 4267G
n PERMIT - APPLICATION AND RECORD
TYPE: BLDG � HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING _ FLOOD PLAW— HEIGHT
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ADDRESS ��D (il1J ��CN�a2D L{J• p�,qN NO. '�
OWNER -+�R, fi/�L��-
DESIGNER /� I
USE/NATURE OF WORK��?1``L�J ""''"uf �Z�t � `DD�T7�'?�� OI�
���A� 1�D/�.1� 1 NDP�� SWInnM� N� �GL.
�a'X'�ES i�-c l r,�C wDE AG-VAL t2-�c_. i�vs�ncut il o�.�
BUILDING CONTRACTOF E�'��� ��''��
Size_—p Sq. Ft. # Rooms # SbrieFs� HeigM
Foundation \ `�NC�L-��� � t'''Au"� Class oi Const o Occupancy Permit�
HEATING CONTRACTOR V��\S C��Z�1 ���
Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S
ELECTRIC CONTRACTOR T K ��-�-1L�L
Electric Serv. New ❑ Change ❑ Temp ❑ Type— Volis_ Amps—
Fitlures Switches Receptades Circuits
PLUMBING CONTRACTOR LARR\\ \-�IJS�7
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_BT —WH —Disp —�NSofl —CBasin
_Lav —Sh _DW —DP —San. Sewer
_WC —FDr —SP —Ur —SlormSewer
—Sink —LTub _Eject —SS —�Nater
Other
FEES: Valuation � � Permit Fee Paid $ -r ' ' "" Park Dedication $
ISSUED BV�, u �� � Data � . �naVO.P.
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In iha peAormance ot ihis wark I agree lo pertorm all work pursuam to mles governing ihe tlescribetl consimction.
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SIGNATURE��, � 1��--`^�� /` `"" �
AGENT/OWNEP 1 ��`�
ADDRESS—L Y' �`�,•s�. V l` {'� L � V" �: fS� S YIJ6 />N� I Z��
TELEPXONE i
� ZONING/LAND USE COMPLIANCE CHECKLIST
JOBLOCATION: �G O �1� G7�tlA6� Li�� ZONING � _
PROPERTY OWNER/CONTRACTOR' ����� f��`�`
CONSTRUCTION DATA: New Construction _� Addition Alteration
TYPE Q� CONSTR�ION: (i.e. fence, pool, parking bt, sign, et�
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COMPLIANCE CHECKLIST
DEFICIENT COMMENTS
Use
Lot Width
Lot Area
Lot Area Per Family
Floodplain
Front Yard
Front Yard Side Street
Rear Yard
Side Yards
Building Area
Parking Standards�
Off-Street Loading Standards
Vision Clearance
Transitional Yard Standards
Landscape Standards
Height
Conditions of Approval
Compliance with P.C. or
BZA Conditions of Approval
Signage Standards
Drainage Plan
REVIEW AUTHORITY
As per Section 30-5 Enforcement of the City Zoning Ordinance, the Diredor of Community Development, o
designee, must approval all plans, except the following� (1) Alterations or interior work when the use is
confortning and when no change in use is proposed. (2) Maintenance items, e.g. siding, windows, etc.,
when the use is conforming and when no change is proposed.
l/ APPROVED DENIED
Plan Commission Action Required
Vanance(s) Requ ed
REVIEWED BY� �l�i �� DATE: l �� ��
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