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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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ADDRESS
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OWNER
DESIGNER
USE/NATURE OF WORK JJ~ S:-l;...)(;L\;' rN'^\L'-);
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BUILDING CONTRACTOR
Size \ Q..~
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Sq. Ft. \ q gl.\
CQc.:L\(E\E
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# Rooms 6 - :3 \3R.
Foundation
Class of Const.
# Stories
~
Height .-J ~'
Occupancy Permit ~ ~
HEATING CONTRACTOR W\CSL~
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
r~" KAAYU () r-
Electric Servo New 0 Change 0 Temp 0
Type
Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR )(oe..-\\
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
::E~~::~at;o~~/~~
Permit Fee Paid $
Date
/
3as~ ~ /
6/3/ q f
I
Park Dedication $
Final/O.P.
!Wo(Q
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /G.A/~ a~L.ir
/ AGENT/OWNER
ADDRESS ~.. ~!() T pM PL~;'7:-i\j
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LId!.. -I sf). 7
TELEPHONE #
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WisconSin Department of Industry,
Labor and Human Relations
Safety arid BuildiPlgs Division
P.O. Box 7969
Madison, WI 53707
Wisconsin Statutes 101.63,101.73
WISCONSIN UNIFORM
BUILDING PERMIT
APPLICATION
Application No.
3i grJ?
Parcel No. ?
......................................................................
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Owner's Name
J<E\JI 1\/ :rAHN~
(See instructions on back of pink copy)
o HVAC 0 Elec 0 Plbg ~ Erosioo
..
...
o Other:
Contractor's Name
Mailing Address
rdl/P fo T61H PLE"JOI\.I
Mailing Address
~{Y\t
Telephone No. (include area code)
.tfllf ~;).C:. -I r_2 7
Telephone No. (include area code)
!~:.:li:IIIII~~~:!.~_~i~I.:,II:! L/105-0 Sa. ft. 1/4, 1/4, Section T.. N,R E(or)W
BUildl~30s SALWAL/ Cr. s~,;;;n;;A~~N Lot NO, 03 Block No.
Zoning District(s) I <tOning Permit No. Front Rear Left Right
Setbacks ;;. 5'" ft. #f'1 ft. I#-' , ;( ft. /Jf ' 6 " ft.
),:DpAGltet:':m:::f;:i:':::m:::m:m:m:i:)::m:::::::::t:iH:lhocdo.pXNcvfH6.llifeEtdtmGXtJ:i:fgJRfiAcBebUlPMENT:i:i:i:1:!YENERttt:sOUkt'eUm::f::f:::::b:Uff)U:::)
'~~w . 0 Repair gSingle Family Entrance Panel ~orced Air Furnace Fuel Nat. L. P. Oil Elec. Solid Solar
o Alteration 0 Raze 0 Two Family Size: .;)60 amp 0 Radiant Baseboard or Panel Gas *
o Addition 0 Move 0 Garage Service: 0 Heat Pump Space Htg,8 0 0 0 0 0
o Other (print): 5Underground 0 Boiler
o Overhead ,gCentral Air Conditioning Water Htg 0 0 0 KI 0 0
::;"/iCo.NSXFIWmiFr11rf.OUNDA1l0Ni 0 Other ~ ~e~~s~~ :~egd ue~~:~:~ :;:c~ 3h~~~;;~:~i p
"RSite Constructed ~oncretei:'1in:PLOMmNG::::r:m::::::r:irrr Infiltration control option is: 0 Full sealing
:::jt:::::AIIl::U'iiltOLVetf:::::::::::":::'::'::::::':::,::::: 0 Manufactured 0 Masonry ................................................................................................................ .. of joints. 0 Blower door test. 0 Exterior
;:':U::lnlsh~~' B~s:~.~~:/~;;:~':'::::.: '~S.f'~tQRlfS}}}}"f'r:I ,;;,~:,~teha:~;:,,:;:;:::,;'@},: g~~~:~iPa I iti:li:'il~~~~l6g*;~Q$$i{~U\v.~i.W~Q)\:r:
"d g1 Story :Jl,.)USl!t.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.......:.:. Permit No E I "eX"! 1010'-/ BTU/HR
Living Area / ( 3 T Sq. ft. 02-Story 0 Seasonal JUtrWAtEg:\::::J:r:::::\\\\\\\: In~~I:r:~i:n ~ -g', 636 BTUlHR
Garage 7 '8 Sq. ft. 0 Other ~6:~:;nent.~'~~.;~I;~;~~.i;.I~~'.'.""'.... j4~:~e$1~Q.tUtOONG(jQ$'::f:,::::::~:;r:::i:ir:::
r$.Plus Basement 0 Private On-Site Well $ 13:3; SOO
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; understands that the issuance of
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This permit is ~ed pursuant to the following conditions. Failure to comply may result tn suspenslonor
revocation of this perm it or other penalty.
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o Other
APPROVAL CONDITIONS
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::t:lssu,:NG"::..:--r:::tf')t::.;:.i 0 Town 0 Village ~ity 0 County 0 State of:
i:JJ:Q$ISBICTIQN':.::\ 05'rlIdoSH q.O_
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~~~~e~i~~w ~ trD~ ~~~~uction Name 't~ ~
WIS. Perm it Seal $$:30. QQ 0 Electrical 61 ."2,; q U
Other 0 Plumbing Date.. ~ _.J
$ 70.~ ~rosion I L/~ObO . Cert.No. 4lD~
Municipality Number of Dwelling Location:
_t(;( 6 ,6_
Total
SBD-5823 (R 07192)
WHITE -Issumg JUrISdiction
YELLOW - DILHR
GREEN -Inspector
PINK - Owner/Agent *
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NAME }{evl tV;; 5IlHJ.JKt'
f63
We 'j ft1v GJ..J
STREET NO. 1530 GAc.lJJA;]
LOT
SUSOIV.
SIDEWALK EXISTING
BUILDING GRADE ELEVATIONS STAKES
FEE; $15.00
CATE h/:JJ9if
AODRESS
SLOCK
'.'IARD
ZONE
~Jr. LOT DIMENSIONS
YES D NO~
SET AT 5 I TE ~A.-./-7 ,19
{7
93
BY ~2----
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I, the undersigned, owner or agenT of the 3bcve described proper't'f agree 'to have ~he
grade eSTaDi ished before excavation has commenced.
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City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address \5?:O. 6ALWA~ OJo\LT
Owners Name \(E\J i lJ :g:\.\-\tJlZE
Name of Subdivision W5"\\\A'J~
Lot # <6b~ Bldg. Pennit # '~~'8
No. of Units
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tlI/Cf)
Fee Required
Fee Paid
Owner's signature
Inspector's signature
Date
Da te 1/49<f
Parks Subdivision
Improvement
Accts. Rec.: 362-041
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JOB LOCA T! ON :
ZONING/LANO USE COMPLIANCE CHECKLIST
ZDNING:
Revisa:i: 8/89
RJ
/530
e.L~JIUI C:r.
KEVIN -:y. rlN KE
PROPERTY OWNER/CONTRACTOR:
CONSTRUCTION DATA: ~NEW CONSTRU~<N ___ADDITION ALTERATION ___PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
A/au !:J~ PAm{~. ~lHed ~~.
/ (tbosc-P /c/?-j #2-) (1qrae;,e--< W;Pf!fL.~)
COMPLIANCE CHECKLIST (Check only those applicable) tv, #84.5 .
COMPLIES OEF!CIENT
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (~~)
Rear Yard
Side Yard (R)
Side Yard (L)
Parking Spaces
Building Area
Lot Area Per .Fami.ly
Corner Lot
Landscaping
Transitional Yard
.
Off-Street Loading
Vision Clearance
Height
-~
DEF!CIENCY/COMMENTS
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REVIElJJ AUTHORITY:
The Director of Community Development, or designee, must approve all plans. excep~ the
following: (1) Alterations or interior work when the use is conforming and when no change
in use is prt'lposea. (2) r~aintenance items, e.g. sid.ing, windows, etc.. when the use is
conforming and when no change is prt'lposea.
Instances where work complies with the above criteria. the permit can be reviewed by the
Building Inspector without ref~r~al to the Director of Community Development, or designee.
L./'APPROVED
Plan Commission Action Required
Variance(s) Required
RE'lmo/ED 3Y: ~?<-<---til/ ~
./ . / .
DENIED
DATE:
6/J /9(
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."" "\'-OWNER.J{EV/N' ~NNKE
rH~~TE iJ 3/ cry PERMIT #~98DR
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GENE~RACTOR
l'~DRESS Is?;O G1(W~ cr.
USE iV.5.F? ArT, E?M~
Wc~k consists of
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MASON CONTRACTOR
Width of lot
ZONE
DATE INSPECTIONS
L /01/1)( I REMARKS
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Front of lot
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.NOT"ICE
THIS BUILDING SHALL NOT BE
OCCUPIED UNTIL FINAL INSPECTIONS
HAVE BEEN MADE AND THIS CARD
SIGNED BY THE FOLLOWING
INSPECTORS
SECTION 7-32 CERTIFICATE OF OCCUPANCY TO BE ISSUED
(A) NO BUILOING 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.
1530 &wA}j Crr<
PRESENT THIS CARD
FOR OCCUPANCY PERMIT TO
Code Enforcement Division
Room 205, City Hall
Oshkosh, Wisconsin 54901
INSPECTIONS MA
BUILDING DATE
ELECTRICAL. DATE
REA TING DATE _
PLUMBING DATE
~J~l/'ls
.
FIRE 236-5241 L DATE
NOT APPLICABLE TO 1 AND 2 FAMILY DWELLINGS
SANITARIAN 238-5030
-DATE
Only for Businesses that Require a Permit from the City Health Department.
CITY SEALER
DATE
Only for Businesses where Scales. PumDs or Scannina Reaisters are UA8d_
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