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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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N!f - 43318
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TYPE: BLDG ~ HTG 0 ELEC 0 PLBG 0 SIGN 0 ZONING
FLOOD PLAIN
HEIGHT
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ADDRESS
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PLAN No.R3- bOl ,~S "'R
OWNER
DESIGNER
USE/NATURE OF WORK~E\AJ S\"-JbLE. ~VV\\L;1
( f,:)O GA"RA6E}
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Foundation
'"Dew~ \-\.eI'A~1
Sq. Ft. 93b # Rooms 5" - Q \31<
C.O~~ Class of Const.
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BUILDING CONTRACTOR
Size '~6"" 3b
# Stories
g
Height
Occupancy Permit 1<~
\4l
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
AM 'E'l\CA0
\-\\""b~
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
C\JM \\JbS
Electric Servo New 0 Change 0 Temp 0
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH
'T\MlS
_WC
_Sh
_FDr
_ L Tub
_Disp
_DW
_SP
_ WSoft
_DF
_ CBasin
_Lav
_ San. Sewer
_Ur
_ Storm Sewer
_Sink
Other
_ Eject
__SS
_ Water
?i-l DOC
FEES: VaIUatiO~~ I
ISSUED BY S~O.2A
Permit Fee Paid $
Date
/
IIS#ci2l
\-'-\,-C\L\
Park Dedication $
Final/O.P.
N/A-
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNAT . , .
,- AGENT/OWNER
ADDRESS
/- ~. .,?.s-
DATE
TELEPHONE #
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ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: /gJr? me f3VRDtj . ZONING
PROPERTY OWNER/CONTRACTOR: vr=wE1j flOfi-{cS I' If^JL,
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CONSTRUCTION DATA:
TYPE OF CONSTRUCTION:
,IUG-D r;;uGLE
,x New Construction
Addition
Alteration
COMPLIANCE CHECKLIST
(Le. fence, pool, parking lot, sign, etc.)
FAIVl/CV, /LJO S,AI246€~
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/-fPu-s e 7 936 fl
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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.
~APPROVED
DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY.~~~::--
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I Wi~consin Department of Industry, WISCONSIN UNIFORM BUILOING
Labor and Human Relations ICATION
Safety and Buildings Division PERM IT APPL
p,O, Box 7969 (See instructions on back of pink copy)
Madison, WI 53707 The information you provide may be used by other government agency
Wisconsin Statutes 101,63 10173 programsIPrivacyLaw,s.15,04(1)(m)].
::,:.liIMi,:,I:~II'~!I!I:':::,llitconstr 0 HVAC DElee 0 PlbgJ8.Erosion
Own~r's Name I Mailing Address
.:})$:. tV~y ~/W~~ jFl/c. /C>?J ;;> 7J/.tZ-~..4-Y
Contractor's Narne: 0 Con ~Elec 0 HVAC 0 Plbg Lic/Cert #
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Contractor:~ame:..q Con 0 Elec Ifia'HVA~.D Plbg Lic/Cert #
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Contractor~ame: 0 CO~[J Elec 0 HVACgPlbg LiclCert #
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Contractor's Name: 0 Con 0 Elec [J1-rV'AC 0 Plbg Lic/Cert #
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Application No. -
l..\ S 3\<8
Parcel No,
o Other:
Mailing Address
Telephone N,O, ,-00
( ) ~'3L -3 -">l}
Telephone No,
( )
Telephone No,
( )
Telephone No.
( )
Telephone No,
( )
Mailing Address
Mailing Address
Mailing Address
:gl~~~II:i~~I,=:~~:::j:.::,:: LOb~t?t> Sq. ft. 1/4, 1/4, Section ,T N, R E (or) W
Building Address , /J Subdivision Name Lot No. Block No,
/1'2.8 /I'1C.CI,ofr/C(14 5f, p,p ~ z~.;$ ,~S" ~/IAfs I 9 5"
Zoning District(s) Illlning PermitNo: , Front T Rear Left Right
Setbacks :2.s ft. I 75; ft, <6' ft l L. ft
:::b:lmOJicrmmm:m:m:::m:rr::m:rrrnm:m:::::m:mr::~:~:m()'QUPA.Ne.Y::::t#te.tlicrm;atrt:n:::~n4iV'Ae.le.WlPMJilN1t}t:n:jll:r'f4lh~*::S.OOICft:r:m::\::::::}}:::m:::::m:m:J:m:m
I ~New , 0 Repair ~ Single Family Entrance Panel [Rforced Air FlJrnace Nat L. P Oil Elec Solid Solar
o Alteration o Raze DTwoFamily Size: /00 amp ORadiantBas~boardorPanel Fuel Gas ..-
o Addition 0 Move 0 Garage Service: 0 Heat Pump Sp ce Htg I1ii 0 0 0 0 0
o Other (print): 0 Underground 0 Boiler a
g! Overhead 0 Central Air Conditioning Water Htg ~ 0 0 0 0 0
:4MCONS1WTYPEil@'fQUNDAllQf,[ 0 Other ~~~~s~~:regd ue7~~~:~ :;avc~ 3h:~~~~~qO~iP.
ol2l Site Constructed ~Concrete :::ji1.::];~ijgMI,N&.:::::::::::::::::::;::::::f::::::::::':: Infiltration control option is: D Full sealing
::.~ujn\fAI"nJI.t'sJh.S 'eAd3,'B'''a"''s:,'e. Dm:Je:i: Vn'::':t'::;:,:i'si'q;,i',iftt; ,: ::'~::;;~;'~~~~:;:~:::m:::{{ ":,:.:,:.8,0,, ",:,.:".,T:::,:."r:,t:"~",~,:"t,r,~::..",,d:r:,:..:Y:,:.:.w:.:.:.:,:.:.:,:,o:,::,:.:.o:,:,:.:".d:.:.:.'.:,:,:,::,:.:.:.:,:,:,:.:,:,:. ~Dewse~pr nt'liccipal ~;(F~~~:~a~o~I~:~i~~~or test, D Exterior
vtmmma'~:::::fllf.llttQ$.':::t@~~ij~;t."ll;;:;:;::
lii:11- Story ;:;,I.:)QSi.:;:;:::;:::;:,:;:::::;:;:;:;:;,;:,:;:;:::::::;: Permit No, Envelope I <)? 1'1~ J DR BTU!HR
~ ~:~:;y ~~:;:::~nt :i1UnWA1al::::::::{{{{{::::::::; H.H.', Infiltration' J I, h,Q):y - 9'-1 BTU/HR
D Othe r ~M u n icipa I Uti I ity::i#.;.::::~$1'11nJ.ltQU\il;:e.QS.jj::::::::::II::::II::III:::
o Private On-Site Well ~ ~ '-1';;(, ()C)O
o Other
Living Area 73tP Sq. ft,
Garage ~Sq,ft,
IljlPlus Basement
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Z\ ") <;;;;(, p..rn 1'7
3.) -:-b,>rAt..t.:
4.) /l1 ft\,JII""tV/V(
The applicant agrees to comply witll all applicable codes, statutes and ordinances and with the conditions of this permit; understands that the issuance of
the'permit creates no legal liability, express O~d, on the Department or municipality; and c7rtifies that all the above information is_accurate,
APPlICANT'S'SIGNATUR~~~ - ~,L -- DATE SIGNED / ~ p.>
APPROVALCONDITIONS This permit is.~JSUanttothefoIlOWing conditions, Failureto comply may result in suspension or
revocation of this permit or other penalty,
~{L E1<s:sIO(.u I J~o.~ ~ JUlIe I RI.l:;;;<;
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nf'["e;;;. O::x..>i:?sP. .I'oND i 1<LJ,---y-.fC 15<Ji?lllec U(vJ:J~'--" Ga7~"""'o,-
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DTown
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o Village ~City 0 County 0 State of:' Municipality Number of Dwelling Location:.
DS:l-\ KCS\-\ 1-0_ - ~ b 6-
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l'5lConstruction
[j'HVAC
o Electrical
QPlumbing
o-Erosion
Name
Plan Review $ 4D
Inspection $
Wis, Permit Seal $ '?::D
Other $
Total $ 70
SBD-5823 (R 06194)
/5Y4bb
Date
:r~~ '-t I \ qCl$
L\6D~
Cert, No.
WHITE -Issuing Jurisdiction
YELLOW - DILHR I
GREEN -Inspector
PINK - Owner/Agent
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GATE :J A I\,) .
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LOT
S USD I V .}6weR..:S
STREET NO. (g a<g
ADDRESS
SLOCK S
4- S"M 1 rn !.s AD,'/::) IV,
!Vi e. f!>>{(Dj ~
ZONE
SIDEWALK EXISTING
YES
, LOT DIMENS IONS
[2]' NO 0
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
, 19
8Y
FEE; $15. 00
~~
. · DEPARn.'ENT DF ?UaL I C "CRKS
I, 'the unders i gned, owner or agenT of 'the above descr i bed proper1"'{ agree 1'0 have the
grade eSTaci ished before excavaTion has commenced.
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IN~PEC~R~, <
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City of
OSHKOSH
RDUGHPLlIM'II'ING
APPRO' , V'
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INSP ~~~
SECTION 7-32 CERTIFICATE OF OCCUPANCY TO BE ISSUED
.' '_m..'_..~___._.~.'.,.....~~ ...~_'^ ..~.'.' '~'''''_'''__''''''''__'
--r THEREOF SHALL BE OCCUPIED UNTIL SUCH
SSUED. NOR SHALL ANY BUILDING BE OCCUPIED
ONFLICTS WITH THE CONDITIONS PUT FORTH
OCCUPANCY.
,.~
Code Enforcement DivIsion
Room 205, Cit~ Hall
Oshkosh, Wisconsin 54901
PRESENT THIS CARD
'/'
\ FOR OCCUPANCY PERMIT TO
ROUGH ELECTRICAL WIRING
APPROV
City of DATE) '1.3 fr
OSHKOSH INSP ;v..--
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DATE IfJ/;c9/fr
DATE. (lJft Lh,Y'/
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DA TE lCJ)~9~
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DATE /0 -7l*-9s
PLUMBING
FIRE 236-5241 .. DATE
NOT APPLICABLE TO 1~ .AND 2 FAMILY DWELLINGS
-
....-r-\ SAN I TAR fA N 236:e;O~~,
-DA TE
Only for Businesses that Require a Permit from the City Health Department.
CITY ~~L~ .. .L4t-d ~ ~, DA TE
Only for Businesses Where~~umps 01' Scanning Registers are used.
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PERMIT :# 0\33\~
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GENERAL CONTRACTOR
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MASON. CONTRACTOR . 'I ZONE
Width of lot
~WNER ~~
DA'l'E i - '-t- q 5'
ADDRESS :l~ M<:.CuRD5 'S\.
USE J...,)Sf= -. I'D ~~
Wc:ck consists~_
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INSPECTIONS
REMARKS
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Front of lot MAiLING ADORESS
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