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PERMIT - APPLICATION AND Rfo;;ORD CITY OF OSHKOSH
ð/k bt/Ae.l4¡<J C;-"'" .. Owner IA.ÀYtJE 6Ayt-1AP-í' "
Block -=- Ward / ç SUbdivision~t21;7.:;;.,V ~ e,A-/ ¡2, &r Zoning-&$Parkland Dedication Fee -.?f/ ~ Height Permit
Fence 0 Pool 0 Occupancy Permit Required ,~ Insp...=Jþ-
BUILDING Use ..d:AJ&L.:£? -f7¡.J.1[L~ I?B,/,¡JE"AJc..GO
General Cont. D-uJJ:t:¡-/L..
Roof /}-Sf>t+A-V[, £..f-l/VG.Ll5S
Foundation ?OU,Q:£?J\ ~ t.E~ Type of Construction
Size: - Hj(¿~L4~ feet long
Height: d- Stories and Basement
~
OSHKOSH
Lot
Address
B
Type of Permit:
PLUMBING CONTRACTOR
Bu, San, Sewer - Curb to Bu.
Bu, St. Sewer Curb to Bu.
Main to Curb:
Main to Curb
Sewer Fees
Water Service
Bath Tub Floor Drain Urinal
Wash Basin - Garbage Disp, - S. Sink
Water Closet - Dish Washer - Catch Basin
Kit. Sink Laundry Mach. - S. Pump ~
Water Heater - Water Soft. B & S Waste -
Shower Bath - Bubbler Conductors
Plumbing Fees Total Fees
HEATING CONTRACTOR '---- :K~:::::::::::7
\
Fuel: Gas 0 Oil 0 Elec, 0 Solar 0 Solid 0
Conditioning Forced Air 0 HoW, 0 Elec. Base 0 Steam 0 Radiant 0
System High Eft. 0 Supplementary 0 Air Condo 0 Ventilation 0
Chimney: "A" 0 "B" 0 Direct Vent 0 Con, Burner 0 Flue Damper & E.I. 0
Calculated Heat Loss System BTU Rating
ELECTRIC CONTRACTOR
Electric Service: New
Description-Type
Fixtures~
Appliances
Changes
Temp,
Volts
Recep's
Amps
Circ's
Switches
Electrical Signs
N~ 23227
Id. No.
Ø=- FIOO~ Plain~
Permit Date3-.:f -Y'5k
Width of Lot
ðlÇ
i7r1J~
U.l:::6LJ f{2AJ/1{=.
Square feet aread-óðð SF
d<+' feet above Grade
::: "~~:ò ~TH-5
Carpenter LJ LJ-
ð
Architect
Siding
"
~t
Inspections -
I"':,'
Footing
Foundation
Electric Service
R.I.
3
~ I Sewer
g-
o
Water Service
s/ ;> Ig 7
Estimated cci13\ ~ I 00 Q Fees Paid 'PI f oL..--V v Date -:;;: --S- ~ g C-,
TO THE BUILDING INSPECTOR: In accordance with Section 7.18 oflhe Municipal Code oflhe City of Oshkosh, it is agreed that if work shall be
discontinued for a period of 30 days at any lime for any cause after excavalion work is commenced, a solid barrier, wall, orwire fence not less than
five feel in heighlshall be erected all around such excavation. SueD barrier, wall orwire fence ~iII remain in position until removal is approved bylhe
Building Inspector. xV" ~
In the performance of this work the undersigned agrees to abi6e by and do
codes, and rules goY- rning the described construction.
(Signed) I ¿
Address /9.2ç C It rt' ¡ r;¡/ I -e '<.A
Owner
Phone '2-.3,)0 Itr)
By
(A",""""", SigoaMe)
Age'
Address
Phone
State of Wi,con,in
Depa"ment of Induwv,
Lebar & Human Relation,
o;vi,ion of Safaty & Building,
Box 7969
Madi,on, WI 53707
WI,con,in Statute, 101.63, 101.73
WISCONSIN UNIFORM
BUILDING PERMIT
APPLICA TION
(See Instruction on back)
~TRUCTURE
MaiI"Y;~" t2q 'N\/' e<A..> C7-
Mailing Addre"
DDetached
ttached
"'2) ','\,
Ba,ements /17/6
Uving Area .;2~o
57(",
~seasonal
Permanent
Other
Garage
APPLICATION NO,.:¿ '3:::t:::l. 7
PARCEL NO.
DPLUMBING
Telephone
';<33 -0 £3
Telephone
,T N, R, Efor)W
Lot No. Block No.
Left Right B
/3 ft.
Fuel S ace Ht. Water Ht.
LP Gas D D
Nat. Gas Po ~
Fuel Oil
Electric D D
Wood D D
Solar D D
Coal D D
Othe,
ŠIG~A TURE OF APPLICANT /.
The applicant agrees to comply with the Wisconsin Uniform Dwelling Code andothe, Muncipal 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
DATE
3~ 5-'6(,."
This pe,mit is issued pursuant to the following conditions. Failu,e to comply may result in suspension 0' ,evoca-
tion of this pe'mit or other penalty.
Plan Review. . . . $
Inspection........$
Wis. Permit Sealfs) . . . $
Other. . , . . . . . . , . $
TOTAL.. .. . $
~î<OêY~-
7¡)
CERT. NO.
GREEN - In,pecto'
PINK - Owner/Agont
DI LHA.SBD 5823 IR. 11/84) WHITE - I"uing Ju""'iction
YELLOW - DILHR
City of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address >?(fp þAJAf<...-/4tU C---r-.
Owner's Name kJf\Y iJlf!i= ~ 'r' ¡---¡'f! h.- T
Name of Subdivision ~~I'=,..J fCA/1't. E:$T"t'fîË'-So.
Lot # d.- Bldg. Permit # ó2:~~ 7
No. of Units /
Fee Required .~~~
:::e:~:dslgnat;::e ~."'_AJ~~Aj/:'
,""",,"" "~"~~~~
Date 3- ç -f:6
Da te '3 -5"-:? '[.,.
Parks Subdivision
Improvement
Accts. Rec.: 362-041
1----
ð
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DATE
6.:~'¿ H A t2. r
ADDRESS
LOT
SUBO I Y .
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
FEE: -J;:¡¡;~!ïo, ö'"
BY kr-l
6, ~¡;J
DEPARTMENT OF PUBL I C WORKS /<',£!:,
I, the unders i gned, owner or agent of the above descr i bed property agree to have the
grade established before excavation has commenced.
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