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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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N! 45236
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OWNER
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PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK G;.F\C')
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BUILDING CONTRACTOR
Size Sq. Ft.
Foundation'~~ ~~S
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HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
0..0~-
Class of Const.
# Stories
<8
Height
Occupancy Permit
# Rooms
NO
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo New 0 Change D Temp 0
Type _ Volts
Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH
_WC
_Ur
_ CBasin
_San. Sewer
_ Storm Sewer
_Lav
_Sh
_FOr
_ L Tub
_Disp
_OW
_SP
_ WSoft
_OF
_Sink
Other
_ Eject
_SS
_ Water
""'<::;, . n 00
FEES: Valua.~ ~erm. Fae Paid $
ISSUED BY .. Date
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~ 001
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Park Dedication $
Final/O.P.
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In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUREP/ """"ow",,, 6-{.-,(r
ADDRESS
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TELEPHONE #
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JOB LOCATION:
ZONING/LAND USE COMPLIANCE CHECKLIST
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ZONING
PROPERTY OWNER/CONTRACTOR:
CONSTRUCTION DATA:
New Construction
Addition
Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.)
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COMPLIANCE CHECKLIST
DEFICIENT
COMMENTS
Use
Lot Width
Lot Area
Lot Area Per Family
Floodplain
Front Yard
Front Yard Side Street
Rear Yard
Side Yards
Building Area
Parking Standards
Off-Street Loading Standards
Vision Clearance
Transitional Yard Standards
Landscape Standards
Height
Conditions of Approval
Compliance with P.C. or
BZA Conditions of Approval
Signage Standards
Drainage Plan
REVIEW AUTHORITY
As per Section 30-5 Enforcement of the City Zoning Ordinance, the Director of Community Development, or
designee, must approval all 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.
kAPPROVED
DENIED
Plan Commission Action Required
Variance(s) ReqUire~
REVIEWED BY: .~
Jkd2g(
DATE:
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