HomeMy WebLinkAboutTemporary Occupancy
"
~
O./H<CifH
~iWA.T~
City or Ollllco4h
!l!Yi.~jon oCWpi:.li~n Scrv\e.j
lIS Ch\II'ChAwrruo
PO Bo.IJ30
O,bkosh W1 ~4901.1130
otD.. ~2o.23(~JMo
fax }1~P'l~G,.$Oa4
~5
l),AWC:S
1E
il~
~
,~I/
I'
1 :3 2006
Tempora.ry Occupancy Permit Application
. Arldress for fue R~q.esterl remporaty Oc~pancyPennit;. .75"'" , . 75L rg:'U~~'Vl ~~)
Occupancy or. Use of S1.T'Ucture: RESI PS.NTt^l.~ ~LJP ~",2.) APAfttM~\13
Building Permit Number:
Issue Date:
AppIican Hnform:9.non
....Name:~4S6'B~u.r :r".A c..o~'D
Com.pany'Name:~JJmc..'TI~ . 9~,~v;. I ~c...
Mailing Address: ~a-;; 'N". ~MNJ?e rriA~ r:;,.... tJ~ J vJ l 5"~~
PhQoe NurOber:.32.C)- g~."B7Cl'G' Fa.x Number: q2,&- ~t::. - ~7C1$
As (check all that apply)~the owner, _the General Contractor, _the Building Permit
Applicant, --*=-.the agent for the owner, I hereby request approval for a ~~~?f~ Occupancy Permit
at the /tr;:cntioned addr,e$S. T,' emporary O~cupancy is requested from ~(date) through
Jj /1'"[ tJ (date.) r understand that Final Oecupancy A.pproval or a Temporary Occupancy Permit
E;cre;;;ioD must be secured by the Tem.porary Occup!1ncy Pettnit expiration date or I may be subject to
Municipal Citation issuance for each day the structure is occupied Without the required Occupancy
Permit
&tedJ d;.lJ~;P---
JO-/O..~
(d:It.:) -
____~___.~_W_____.__~___.______M4____.______~W____._~______~____________~_____~4_______~_~~____.._.__.__.___R_._~_.~.~__...~~_
Appli.cation Sta.rns: / Approved
(Offil:C U~e Only)
_Denied Expiration Date:JiliU~ Fee Collected .1t JOO ,00
L~l1d5:r " 1:0 he. COJ'Vlf/ebJ. ~
4.frrulJ 0\
Comments/Conditions of Approval;
_-f'J.r6.0~I'nt d~~"~ ~ IIi
. Reviewing Inspector: ~:a~
Date:
/OI/3/tJ0
I (
God
EOl.BSBBOGS
SLSIIHI~3dS 8~IL~H~L~O~ WHGO:Ot sOOG Ot ~oo
I
.-.... . 'C "....., ___,_..." __.._"_ ,. _,___.'_ --c- . '-___....... _.___,_'___~,___, "'_'_~"_."_'''''
~
CORRECTION NOTICE / FIELD INSPECTION REPORT
7s-
CONTRACTOR: --r;/ 5&/'
PROJECT TO BE INSPECTED:
TYPE OF INSPECTION:
~
JOB LOCATION:
~ 1A:)e~
City of Oshkosh
Inspection Services Division
215 Church Avenue, PO Box 1130
Oshkosh, VVI54903-1130
Phone: (920) 236-5050
Fax (920) 236-5084
fl- fJt-
/7;, If I
Violations must be corrected and approved within 30 days unless otherwise noted. Call for re-inspections prior to concealment
and/or occupancy. Upon completing the corrections, the owner/contractor/agent must sign and date at the bottom ofthis notice
and return it to the Inspection Services Division by the Compliance Date of
il1l:E'Mtt, conE , INSPECTION RESULTS "'>::,..' '<,:'," :/,':"'.:"~
I Wett~r e. t,! J) ~~A G'I'\ I "d,,- A-hllC- ac.<..e0
Z S.e",- \ ,np n€-JYeftJdn r /n !AlA II~ d- re.i'I'hl: or JI1et1 ~"']nhl"
I .J
.3 75 D
" cJ r.Ji:/~ pe J.,/~J s t.." Ar!.-
e /../'1// ~. rOO/Y1 c/;"'clj/'-6. S), 0;0 d:./ :. . o v&-
'" -'
'."" ,.
Print Name
Company
Signature:
Date