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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
lID
-
N2 40123
TYP :
BLDG ~ HTG 0 ELEC 0 PLBG 0 SIGN 0 ZONING Y FLOOD PLAIN
HEIGHT
. - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ADDESS I~~
OJER (lASS I e
DESibNER
USE) ATURE OF WORK'
!N/) IO'~
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~Jm
HomEs
E>1KWCDD RctV)
By J(u B4 I L rD
PLAN NoFQ- 0<1'3 b)q4~
A1TAC;{ED
9'I~ #
(
aNU~ ~ IN
BUIJ ING CONTRACTOR . LASS\ e.. ~~' .
izeY~ Sq. Ft. -QoSO # Rooms f- ~BJ!
oundation C!JNCRETe Class of Const.
~ING CONTRACTOR '1Sf'/;;we:R
fHeat 0 AlC 0 Vent 0 Fuel/System Heat Loss
# Stories
g'
J~ ~/\
J\.X, Height (YV
Occupancy Permit ~
BTU'S
ELE TRIC CONTRACTOR
~tlo;nmeR
lectric Serv. New 0 Change 0 Temp 0
Type
Volts _ Amps_
Circuits
ixtures
dSING CONTRACTOR
Switches
Receptacles
;VJ~r~
BT
_WH
_Sh
_FOr
_ L Tub
_Disp
_OW
_SP
_ WSoft
_OF
_ CBasin
WC
_Ur
_ San. Sewer
_ Storm Sewer
_ Water
Lav
Sink
_ Eject
_SS
Othe
FEE : valuatl~ i./ 5} cx:o Perm. Fee Paid $ 1'-1 a. so
ISS lED BY .QiJ\ ~~ Date-hl-a31q4
~ . -
In t pertormance of this work I agree 10 perlorm all wol1< pursuant to rules governing the described construction:
SIGLT. E - 2-
AolESS
il
!
Park Dedication $
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Final/O.P.
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VQ- 0Cl3
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WISCONSIN UNIFORM
BUILDING PERMIT
APPLI(A TION
(See instructions on back of pink copy)
'.
Appllcati.on No.
i)O/ f)S
Parcel No.
.
WISCOrl~1n Department of Industry,
Labor ~nd Human Relations
Safety ~nd Buildings Division
PO Bd~7969
MadisQln,wl 53707
Wisco~ in Statutes 101.63, 101.73
. ~
:!::!'::~~!~~~~m!IIII~~'~:I!I!iii:iil::: &tlconstrD HVAC DElee
owner'~1.Name ,I Mailing Address
~ f/ ~ ~t-I...~ 'b.J ~ '=- ^- - "\ S:?r
Contrac ,or's Name 'Mailing Address
III \ It t l
D Plbg (f)(Erosion D Other:
'Telephone No. (include area code)
~~,&. (I~ 1 F_ J.?f_ - ~CO
Telephone No. (include area code)
{ t H H tf
!i!!i:i::III!~~ilii~illillli!iil!ii ,~ SQ.ft 1/4, 1/4,Section
BUi,!q.tj(!:Y ~bJn.\- ~~~D gD S~~o~~ ~ rl\J~~~ LotZ;'/l
Zoning Qistrict(s) I Zoning PermitNo. Front I Rear..,., Left Right
Setbacks Z;:, ft. ], ~n p! ft. 12 nS ft. ., ')..., C 50 ft.
tiUtPRtlJEttlg::?!t!:!::!???:??::::UU::?:!:::m::aW:(jeeupjiMif::L:I.UetE(ljjijGAV?:::JJl:HvAc:eC'l1liMENilttU::12XJENERdv?OUnOE::!:!::?tt:!::?::t:t:::?????
~~w !, 0 Re.pair l..QI\?'ingle Family Entrance Panel '1:3.r6rce. d Air Furnace F I (l1..iat Jl P. Oil ElK Solid Solar
OAlter~tion 0 Raze IrOIWO Family Size: WIiI' amp TIRadiant Baseboard or Panel ue:- *
o Additj;on 0 Move 0 Garage Service: 0 Heat Pump Space Htg ~ 0 0 0 0 0
JI 0 Other (print): <:: ~nderground 0 Boiler
o Overhead 0 Central Air Conditioning Water Htg .I2J 0 0 0 0 0
.~,~,h':"'...'I..'..P.'_"Wii ~~~~!m;~i ~~_i_i s~~!~~!~i~~~1f.~:~~~!~i~;
.:.2~.:.:AR!AJNV01;:'VeQ:.:.:.:.:.:.:,:.::.:.:.:.:.:.:.:.:.:. 0 Treated Wood Sewer . . fit t' b .
.. I! ....- ::!sW?SrOlles.?:t:!tttt 0 Other ~unicipal air In I ra Ion arner.
Unfln Ishrrd .Basement_ Sq. ft. "0" ..... .,~.... ............ ..... ...... ::::o::::::o~:~::::::::::::::::::::::::::::::::::::::::: 0 Septic !:!:!::!J!::~:J:;:::H~A1t:~Q$.!$:(qiil.~tqNit"q)(:)
:ze:;s;. 1- tory ::::~.::::M:~"":::::::::::::::::::::::::::::::::::::::::::::::: Permit No Envelope ~. l"'~","' '60 BTU/HR
Living Arra 0 Sq. ft'l ~-1Story 0 Seasonal i'f!1d'WAtfEtt:::::i'i'i'?:?tt:!i':: Infiltration 1'(;.., 41 b. S...J.; BTU/HR
Garage i! -, ~?---'Sq. ft. ro~ :~e: .-,,, L..-1 ~~~:;nent :B;~~'I~i'~~;C'~;'I'I~~""""""" '1!4~::e.$I8!ao.~tQt:N&~Q$t::!n:::!!::u:!n:: ........
Ii 0 Plus Basement 0 Private On-Site Well $ ~S. Doe:>
The app'f'ir ~o' """ '0 oomp'y with ,II 'ppli"bl, ood", '''''''' .od o;~,'" ,od witli th, <ood"'oo, ofth" pNmit; "od'<<',od, 'hot th' '''"'0<001
the per1it creates no legal liability, express or implied, on the ,?e~V ~unictality; and certifies that all the above Information is accurate.
APPLI, ANT'S SIGNATUR~J\\m A '- ~ .A...-/ ~ DATESIGNED~'" (P~2-I-~~
APPR()V AL CONDITIONS t hIt permit is issued pursuant tothe following conditions. Failure to comply may result in suspenslOnor
~v}>catlon of thiS perm It or other penalty.
/..) JJ/~rACL s;;,.c. €1lo5foU FV,'....."'c,ty?...es 1::::€R ILf/~ Ql.I:2S;
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N,R E(or)W
Block No.
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Illiii~lt.:~".... 0 Towo 0 ViII", ~~, _ ~. ~,y 0 '"'' of M"""'i>'h,y ,~tQ DW';3 ";t;;;
................................. ~l-h~ - - _
~__.i~.~
WIS. Perrrjit Seal $'30c<'" 0 Electrical /L ~3. L t1L1 J
,Other II $ 0 Plumbing Date ~_Gi'- _ _ 77
Total 11.. $ ?o.~ ~rosion 1'-/'a070 Cert.No. i.fbtit
..'
.
. .
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SBEl-5823'kR.07/92)
!
II
WHITE -Issuing Jurisdiction
YELLOW - DILHR
GREEN - Inspector
PINK - Owner/Agent *
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CATE
NAME
KV-~A-
~/7
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S uso I V . 4 a9e...s tf-t.~J ~VJ ZONE
STREET No!77o $'. ~kuJODtf7 I~ lOT DIMENSIONS
YES 0 NO 0
BUILDING GRADE ELEVATIONS STAKES SET AT SITE },.,.1 .2..5 ,19
AOORESS
lOT
SlOCK
~'l ABD
SIDEWALK EX I ST I NG
FEE, $15.00
9'''; BY ~_
/~ ;g~~
OEPART~ENT OF ?u8llC WORKS
Oot-o~""o
,. "" /"
'__ "..:..JU.,,~ ;; -
to have the
I, the undersigned, owner or agenT of the above described
grade eSTaCi ished before excavation has commenced.
City Of Oshkosh 1/1/85
~
PARKLAND DEDICATION FEE COLLECTION RECORD
Address It "10
Owners Name c:lPr--;;t;. \ e.
Name of Subdivision L\+"-
OAKwocb ~i
b~ K~~~ ,
f\PO \\.:)" "fD w~ \-\A.\JE.)...J
~.
~~
L U::>
LID} 93
Lot I
6/7
No. of Units
Fee Required
Fee Paid
te
Owner's signctur
6/~3/q,-/
.
Date
Parks Subdivision
Improvement
Accts. Rec.: 362-041
II
'" II
II
ZONING/LAND USE COMPLIANCE CHECKLIST
JO LOCATION: JJ?O. ,<;;. DXWCCi) 'ZJ1S. ZONING /-(
PR PERTY OWNERlCONtAACTOR: CUSSIC ;buES By Jr:6/Y1, I ~.
COLSTRUCTION DATA: ~ New Construction Addition
Alteration
(Le. fence, pool, parking lot, sign, etc.)
~
/llM I L
~;
Use
Lot Width
Lot Area
~ Lot Area Per Family
~ Floodplain
Front Yard
Front Yard Si
Rear Yard
Side Yards
, Building Area
Parking Stan
Off-Street Lo
Vision Cleara
Transitional Y
Landscape St
Height
Conditions of
Compliance
BZA Conditio
Signage Stan
Drainage Pia
Rd viEW AUTHORITY
A~iper Section 30-5 E
de i nee, must a rov
de Street
dards
ading Standards
nce
ard Standards
andards
_ ~I;OJ ~
Approval
with P.C. or
ns of Approval
dards
n
nforcement of the City Zoning Ordinance, the Director of Community Development, or
g pp al all plans, except the following: (1) Alterations or interior work when the use is.
cotforming and when no change in use is proposed. (2) Maintenance items, e.g. siding, windows, etc.,
whem the use is conforming and when no change is proposed.
..11-....... . ~PPROVED
EplantommiSSionAction Required
DENIED
Variance(s) Requir d
e/a;-~
DATE:
4/iftlr;
OWNE~5S/e ~ 0/ }(oa4, L[l} ADDRESS tno ~. QI/~wa:'i) /(b, .
DATEI::/a3/qL/ PERMIT # 4DI a3 USE NsF -A7T; SAIM.{;!F - DelX
~ 4a.-b ~6o::J Wc-rk consists of
GENERAL CONT RAC TO R ffi' .
MASON CONTRACroR -ZONE ~::~:~D <I:;;' )~
Width of lot DATE INSPECTIONS
- REMARKS
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Front of lot
I(~ ~~()~~ NOtiCE
ROV.ED ~~1\PPBQYED
os q :.t:~.:"~='i,i:y""cif:;:' 'DAfE.'~___
~bl'00~0~"OSHKOSH INSP ~s
y.. ;~.. .~.. g 'g'.,...~. nn..,_mn'__n'~'-
DUGH EI.EcjRiCArwilNG~~: FOLLOWING
APPROYE,. ~ POUGH PLUMBING
'O;~%;~H ~~~E tJ ;:5 ORS APPROVED
--~City of DATE /0-/3 -:7~
OSHKOSH INSP .~
SECTION ]-32 CERTIFICATE OF OCCUPANCY TOclfl:~V1:i;r--~_n_- .~_. '"
(A) NO BUILDING OR PART THEREOF SHALL BE OCCUPIED UNTIL SUCH
CERTIFICATE HAS BEEN ISSUED. NOR SHALL ANY BUILDING BE OCCUPIED
IN ANY MANNER WHICH CONFLICTS WITH THE CONDITIONS PUT FORTH
IN THE CERTIFICATE OF OCCUPANCY.
ESENT THIS CARD
--r\ F R OCCUPANCY PERMIT TO
" '
Code Enforcement Division
Room 205, City Hall
Oshkosh, Wisconsin 54901
/
ISPECTIONS. MAY
G'ED BY CALLING 236-5050.
rS NIT ARIAN 236-5030
o A Tpjf);IIJJ~~
DATEJY~ky
DA TE/~o/;-z1
P _ DATE //--~CJ/7'y-
. t /
F RE 236-5241 ~ DATE
NOT APPLICABLE TO 1 AND 2 FAMilY DWELLINGS
-DA TE
Only for Businesses that Require a Permit from the City Health Department.
C TY SEAJ"ER
I _. . _
DATE..