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Home My WebLink AboutBuilding CITY OF OSHKOSH N° � 8�3z ' n PERMIT - APPLICATION AND RECORD TYPE: BLDG�HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING � I -- FLOOD PLAIN� -'� HEIGHT,.Lz'[— " " _ ' _ " ' _ " " ' _ " ' _ _ " " ' _ " ' _ _ _ " ' _ " " _ _ ' " " _ " " ' " ADDRESS � ��' � �� OY' aY �t� . .. PLAN NO. S �� OWNER / l '� �' ' � DESIGNER—. -- - USEiNATURE OF WORK �9�� r ' ��O �7�-�.'7 e_su.:l� BUILDING COMFACTOR -- � " _ { � � Siz� S/qI R � 67� #/Raoms��` �a -\# Stories � Heigh� �7 Fountlation ��e-'•`•E( � -� .. Class of ConsL�:-- Occupancy Permit�� HEATING WNTRACTOR — � Heat ❑ A'C ❑ Vent ❑ Fuel,�Sys�em . Hea� Loss BTUS— ELECTRIC CONTRACTOR�. Electric Serv. New ❑ Change ❑ Temp ❑ Type— Vol�s— Amps— Fixtures Swimhes— .— Recep�acles_ Circuits PLUMBING CONTRACTOR�<<:Y�"� - —� � BT WH .Disp WSoft CBasin _Lav —Sh DW —. DF San. Sewer WC ..FDr SP —Ur Storm Sewer _Sink LTub —Eject SS —Water Other FEES'. Valuation O P r it Fee Paid $ �� Park Dedication $ issueo ev oe�e � " "'�— 90 — F�auo.P.,/c%z 9 %G � � In �he pertormance ot ihis work I agree to padorm all work pursuan. lo mles goveming ihe described wnsimction. SIGNATURE � �'^ � -� � � - — — —� � �rE �O AGENTOWNEP /j�� ADDRESS G{S W� D �" " 73y'/ZS� TELEPXONE.1 1Z - 35-3�v s�a�eo�w:000si� W�SCONSIN UNIFORM Departmen�oi Intluslry, Labor&HumanRelations gUILDING PERMIT APPLICFTIONNO. 1 Dlvision of Safery&Bullaings Mae��,wi sa�o� APPLICATION . Wisconsin5laWtes101.63,101]3 See/nshucfionsonbeeko/ Inkeo PARGELNO. �PERMITREQUESTED � STRUCTURE ❑ HVAC ❑ ELEC ❑ PWMBING Owner s Name Mailing Address Telephone S�� Convactor s Name Mailing Atltlress/ Telep�one �/r «'� � e.S / —tc�.aadi — 7 PRO ECT LOCATIQN �� ' � � � Y., %,SECTION J—N R E or W BuIIEIngAddress �� SubtlivigionName Lo1No BlockNo. 3a � f��-t � .. � � � Zoningoisinc LotArea Fmnt Rear leX RigM s .n. Selbacks n. �--r n. 7• n. 7i�_ n. 1a � HOJECT . �.�. � B. TYPE 6PELEGTPICAL�� 9. HVACEQUIPMENT � 12. ENERGYSOURCE� . w ❑Atltlition 0 Paze Single Famity EnUan$��aJle,l ForceJ Pir Furnace Fuel HaL L P. OII EIec.Solid lar ❑Flte�a�ion ORepair ❑ Move �Two�amily Size:TFJV amp 0 RatllanlBaseboartlo�Panel G s . ❑OtM1er Service' ❑ Nea�Pump SpaceMg. ❑ ❑ ❑ ❑ ❑ ❑Omer nEergraune �oiier waterHtg. ❑ ❑ ❑ ❑ ❑ ❑Overheatl Genval Air Condltioning .0 owen ng un t w u heve a x'iowae or 1b. GARAGE � LCON52T'1FEA'�POUNDATION o�ne� -�:�aneaeia�o-�sva=enaarogew�o. vacnea ❑ oetacned ��econsimcte oncrete 10. PLUMBMii � � i �'i� � t i v� '�:�F�iisearng ❑ManulacWred Masonry ewer �i - � . ❑ei a test OExteror .2;.AREl4 �,..�� ❑ireateaWooE unicipal '�n1°'a�°"�a"ef. easemems ��t�s n S.'9T4AIES .. � ❑omar ❑ seorc 73. NEAT IOSS�Caitblatedl ��. � �B.�USE Permitr�o_ e��eiove �'�� ❑1 �ory SZ�O BTU/HR.�. LivingFrea�1��_a/se—sa.n. sm.y ❑see:o�ai 11.�WATER ' imo-a��on � emiHa ca.ega �.u�sq-n. �omer e.r�anem htunimpai umiry 14.�ESTIMATED CO$T �� ef Privateon-si�ewell $ The apPlicant a8/ees to compty wit�t�e Wisconsin Unilorm Dwelling Gotle and other Municipel Ortlinances anE wit�ihe contlitions of Ihls permlP,understanGs IM1a�tM1e Issuance oi��e permi�crea�es no legal li bili�y,evpress or implieG,on t�e Oepatlment o�MuniciDallty;end cer�i�ies�ha�all��e a�ove in�o�malion is accurele. SIGNATURE OF APPLICANT onre CONDITIONS OF APPROVAL This permit �is �issued pursuant ro me foilowinq conaitions. PaiWre m compiy may resuu in suspension or revocetion of ihis permit or ot�er penalry. r' � v ��o � � ' e O v� l ` c t � � � �r 0�. � „r �-- r � , w s ❑TOWN ❑VILLAGE ITV ❑ COl1NTV Municipali�yNumbero� MunicipalityNumbarofDwelling �S$V�NG ❑STATE ❑ N� Ins ec�ionAuthority Loca�ion,i�different JURISDICTION oF: �'(�-�i�r fa --— — — FEES: PERMITS) W15.UNIFORMPERMR pERMITI53UEDBY: � � �. � � ' �� ISSUE� 9EAL NO. � �//�/ PlanReview . . . 8 � HVACmction I NAME ' + �� K .�...�k� . . � Inspection . . . . $ ❑ Elechical ' Wis.PermilSeal�s) S �— Q Plumbing JJJ 0/TE �./ � Q Otber . . . . . . E ❑ OtM1er �SZ(a-% CERT.NO. "�'-�b TOTAL . . . S �— � SBD592J�F.00/B]) WXRE-IssuingJutlaUltllan VELLOW-OILHR GFEEN-Inspector PINN-Owner/Age^� '7m�l iv�✓i — �4C�D � , Revised: 8/89 ZONING/LAND USE COMPLIANCE CHECKLIST , JOB LOCATION: '�� G Z C7 �-�� e-c �� z< � � ZONING: � I . ` PROPERTY OWNER/CONTRACTOR: 7`- /-�4 � CONSTRUCTION DATA: NEW CONSTRUCiICN ADOITION ALTERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, paol, sign, deck, etc.) l� �r �� 1� -� � ��1� C< <-- ��G� � �� -� COMPLIANCE CHECKLIST (Check only those applicable) COMPLIES DEFICIENT DEFICIENCY/COMMENTS � Use Lot Width Lot Area � Floodplain Front Yard Side Street (frart yard) Rear Yard Side Yard (R) Side Yard (L) � Parking Spaces � Building Area � Lot Area Per Family Corner Lot Landscaping Transitional Yard � Off-Street Loading _�_ Vision Clearance Height REVIEW AUTHORITY: —. �J�� :�etC/ c7 �/✓� '��«F- ��G�GJS, The �irector of Community Development, or designee, must approve all plans, except the following: (1 ) Aiterations or interior work when the use is conforming and when no change in use is proposed. (2) Maintenance �items; e.g. siding, windows, etc. , when the use is tonforming and when no change is proposed. Instances where work complies with the above criteria, the permit can be reviewed by the Building Inspector without referral to the Director of Cortmunity Development, or designee. v-APPROVED DENIED Plan Cortonission Action Required _ Variance(s) Requir�d . � i REVIEWED BY:�� !/ �----" DATE: 3��0 l� � ��'�� c;ty of osnrosn t/t/as PARKLAND DEDICATION FEE COLLECTION RECORD Address � 2 7 C' �/�.Q SJc��u-,k' h�k« 't Owner's Name ./ �r �� Name of Subdivision /��itit�.—� �v�'a �.7- Y Lot N Z Bldg. Permit q / g7� 2- No. of llnits / Fee Required i�o Pee Paid �f�� Owner's signature � � �� Date Inspector's signat� e .�.b�c� Date L� � Parks Subdivision Impravement Accts. Rec. : 362-041 �'''' onre � — z� � ADDRESS .. NAME �_� �� LOT �_ BLOCR 'JdRD SUBDIV. �� 2 ` ��S ZONE STREET N0.3da� ��J �p"c � rcV �v� - LOT Dli`4ENSIGNS SIOEWALK EXISTIPJG YES � �0 � � � r� BUILDI�G GRADE ELEVATIONS STAKES SET AT SITE�z_� �`' BY �� fEE: 515 -00 �� . �` <� � l � DEPARIME?JT OF P�BUC WOrcK$�� I , the undersigeeC, owner or agent of the above descriceC property agree to Fave 'he grade es�ablishec be4ore excavation has commenced . ��,�.� � �D �/L � . ., t��3 bi 13 I ut ail l .Pt> ,p.�IV1 ",I Idwb C,w�l-d LIt;1NU'x7fu' �; J U 1 am M AiNCrj? ��B911PVN�I�N n .. ,_I�Kw, NNE E i y41�N i x fl � � F C" {