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Home My WebLink About0110440 BOSHKOSH ON THE WATER .lob.Address 3080 LAKE REST LN Designer Fox Cities CITY OF OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD Owner JOHN G SAMSTER JT REV TRUST Contractor FOX CITIES CONST CORP Category 110 - New Single Family No 110440 Create Date 09/08/2004 Plan F1-088-0804R Type IO Building (~ Sign (~ Canopy (~ Fence (~ Raze Zoning R1LO Class of Const: VB Size 51' x 57' Unfinished/Basement 0 Sq. Ft. Rooms 2 Height 19 Ft. L~ Projection J Finished/Living 1662 Sq. Ft. Bedrooms 3 Stories 1 Canopies 0 Garage 582 Sq. Ft. Baths 3 Signs 0 Foundation O Poured Concrete ~ Floating Slab ~ Pier ~ Other ~ Concrete Block ~ Post ~ Treated Wood Occupancy Permit Required Flood Plain Yes Height Permit Not Required Park Dedication Not Required # Dwelling Units 1 # Structures 1 Use/Nature NSFR/New single family with attached garage, driveway, and 12' x12' patio as per plans. CERTIFICATE OF ELEVATION AS REQUIRED BY of Work COMM 21.33 (3) REQUIRED PRIOR TO OCCUPACNY! HVAC Contractor MCM AIR INC Plumbing Contractor JIM'S PLUMBING & HEATING INC Electric Contractor ELECTRICAL CONTRACTING SPECIALISTS Fees: Valuation $140,300.00 Plan Approval $75.00 Permit Fee Paid $532.00 Park Dedication $0.00 Issued By: Date 09/10/2004 Final/O.P. 00/00/0000 Permit Voided Parcel Id # 1415730000 In the performance of this work I agree to perform all work pursuant to rules governing the described construction. While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work described in this permit application within an easement, the City strongly urges the permit applicant to contact the easement holder(s) and to secure any necessary approvals before starting such activity. Signature Date Agent/Owner Address 4614 RED FOX RD OSHKOSH WI 54904 - 0000 Telephone Number 235-8008 To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may continue if the inspection is not performed within two business days from the time the project is ready. OSHKOSH ON THE WATER Name JOHN G SAMSTER JT REV TRUST GRADE STAKE FORM Lot 1 Block Subdivision replat of lake rest manor Zone Street Number Lot Dimensions Building Grade Elevation Stakes Set At Site 09/08/2004 Set By Grade Stake Number 7200 Address 3080 LAKE REST LN Create Date 09/08/2004 1 Ward irrg ~J Sidewalk Existing Department of Public Works I, the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commenced. Wisconsin Department of Industry, WISCONSIN UNIFORM Application No. Labor and Human Relations Safety and Buildings Division BUILDING PERMIT 0110440 P.O. Box 2509 APPLICATION Parcel No. Madison, WI 53701-2509 Wisconsin Statues 101.63, 101.73 [] Constr [] HVAC [] Elec [] Plbg [] Erosion [] Other: Owner's Name Mailing Address Telephone No. JOHN G SAMSTER JT REV TRUST 3570 WOODBURN CT BROOKFIELD WI 53005 - 2238 Contractor: L~J Con~J Elec~J HVAC ~J Plbg Lic/Cert # Mailing Address Telephone No. FOX CITIES CONST CORP 1305 4614 RED FOX RD OSHKOSH WI 54904 - 0 235-8008 Contractor: ~J Con ~J Elec~J HVAC~J Plbg Lic/Cert # Mailing Address Telephone No. ELECTRICAL CONTRACTING SPECIALISTS LL¢ 662631 8196 GALAXY DR NEENAH WI 54956 - 0 920-428-7000 Contractor: ~J Con ~J Elec~J HVAC [] Plbg Lic/Cert # Mailing Address Telephone No. MCM AIR INC 4264 6122 COUNTY ROAD M WINNECONNfW 54986 - 9780 920-582-4402 Contractor: ~J Con [] Elec [] HVAC [] Plbg bio/Cart # Mailing Address Telephone No. JIM'S PLUMBING & HEATING INC ~6166 GREENVILLE DR GREENVILLE WI 54942 - 0 920-757-5258 Lot Area Sq. ft. 1/4, 1/4, Section ,T N ,R E (or)W Building Address Subdivision Name Lot No. Block No. 3080 LAKE REST LN replat of lake rest manor 1 1 Zoning District(s) Zoning Permit No. Front Rear Left Right Setbacks ft. ft. ft ft. L~J New [] Repair [] Single Family Entrance Panel L~J Forced Air Furnace Fuel Nat. L.P. Oil Elec. Solid Solar [] Alteration [] Raze [] Two Family Size: 200 amp [] Radiant Baseboard or Panel Gas , [] Addition [] Garage Service: [] Heat Pump Space Htg [] [] [] [] [] [] [] Move [] Other (print): [] Overhead [] Boiler Water Htg [] [] [] [] [] [] [] Underground [] Other: [] Central Air Conditioning * ~J Dwelling unit will have 3 kilowatt or [] Other = more installed electric space heating equip. [] Site Constructed ~ Concrete Infiltration control option is: [] Full sealing Unfinished [] Manufactured · Masonry Sewer of joints. [] Blower door test. [] Exterior Basement 0 Sq. ft. ~ ~ ~Ri~ <~ Treated Wood [] Municipal air infiltration barrier. Other Living Area 1662 Sq. ft. [] 1-Story [] Septic Garage 582 Sq. ft. [] 2-Story x8 ~ ~[] Seasonal Permit No. Envelope 66855 BTU/HR [] Other Infiltration 20946 BTU/HR [] Permanent [] Municipal Utility .~ ~ ~i ~i1~,1~ ~ [] Plus Basement [] Other [] Private On-Site Well $159,400.00 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 or implied, on the Department or municipality; and certifies that all the above information is accurate. APPLICANT'S SIGNATURE DATE SIGNED This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or APPROVAL CONDITIONS revocation of this permit or other penalty See Standard conditions of approval@@@@Must also comply with UDC Subchapter X - Construction in flood plains [] Town [] Village [] City [] County ~J State of: Municipality Number of Dwelling Location: City Of Oshkosh 7 0 2 6 6 ,/ Construction Plan Review $75.00 _ HVAC Name Brian Noe Inspection Electrical Wis. Permit Seal $30.00 [~ Plumbing Date 9/8/2004 Other [] Erosion Total $105.00 · 306918 Cert. No. 70266 SBD-5823 (R. 07/92) OSHKOSH ON THE WATER Job Address 3080 LAKE REST LN Name Address 3570 WOODBURN CT Subdivision r~lat of take rest manor Building Permit Number 0t 10440 Number of Dwelling Units Fee Required Owner's Signature Inspector's Signature PARKLAND DEDICATION FEE COLLECTION RECORD JOHN G SAMSTER JT REV TRUST BROOKFIELD Lot 1 Date 09/10/2004 WI 53005 Number of Structures $0.00 Fee Paid Date Date ZONING/LAND USE COMPLIANCE CHECKLIST JOB LOCATION: 3080 LAKE REST LN. PROPERTY OWNER/CONTRACTOR: FOX CITIES CONSTRUCTION CONSTRUCTION DATA: [] New Construction [] Addition ZONING: R-1 [] Alteration TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.) NEW SFR, ATTACHED GARAGE COMPLIANCE CHECKLIST DEFICIENT [] Use [] Lot Width [] Lot Area [] Lot Area Per Family [-] Floodplain [] Front Yard [] Front Yard Side Street COMMENTS: DEFICIENT [] Rear Yard I--] Side Yards I-"1 Building Area [-I Parking Standards ~1 Off-Street Loading Standards [-] Vision Clearance [] Transitional Yard Standards [-I Parking Lot Lighting DEFICIENT [] Landscape Standards [--I Height 1--] Conditions of Approval [-] Compliance with P.C. or BZA Conditions of Approval [-I Signage Standards [-I Mechanical Equip. Screening [-I Other OHWM DETERMINATION OK, VER'D 8/19/2004. FRONT YARD SETBACK REDUCED VIA SETBACK AVERAGiNG. THIS STRUCTURE IS BEING BUILT WITHIN THE 100 YEAR FLOODFR1NGE OF LAKE WINNEBAGO. MUST PROVIDE BEFORE OCCUPANCY IS APPROVED: · VERIFICATION OF BASE FLOOR ELEVATION OF DWELLING AT A MINIMUM OF 751 FEET ABOVE MSL. · IF CRAWL SPACE IS PROPOSED, CERTIFICATION OF FLOODPROOFING FROM A STRUCTURAL ENGINEER · VERIFICATION OF REQUIRED 15 FOOT FILL RADIUS AT 750' ELEVATION AROUND ENTIRE PERIMETER OF STRUCTURE. REVIEW AUTHORITY As per Section 30-5 Enforcement of the City Zoning Ordinance, the Director of Community Development, or designee, must approve ali plans, except the following: (1) Alterations 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 conforming and when no change is proposed. APPROVED [] DENIED Plan Commission Action Required BOA/Variance(s) Required REVIEWED BY: Matt Tucker 2003 THE SAMSTER RESIDENCE 3080 LAKE REST LANE SCALE: 1" = 20.00' INDICATES DIRECTION OF DRAINAGE INDICATES PROPOSED ELEVATION 7XX.XX SILT FENCE (TYP.) PROPOSED GRADE AT HOUSE 750.33' (T.O.S. = 751.00') SETBACK PERIMETER " (TYp.) ,, 12'X 12' PATIO MEANDER LINE ('rYP.) HIGH WATER MARK PER CONVERSATION BTW/MATT TUCKER AND STEVE POESCHL 8/19/04