HomeMy WebLinkAbout0006468-Building
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECOR
N~
06468
TYPE: BLDG~HTG. 0 ELEC 0 PLBG 0 SIGN 0 ZONING 1< f
FLOOD PLAIN
HEIGHT A.JlII-
ADDRESS
PLAN NO.LJ L -..:S7l?-/{~ t:.
OWNER
DESIGNER
USE/NATURE OF WORK /!/.
foc90
BUILDING CONTRACTOR
SiZf?-~ Sq. R (~ i~
Foundation p~
# Rooms 7f-LY"L
# Stories
,~ '" (Height (:. 'L
Dcc"pa cy pe<m;,-V-
Class of Const.
s
HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
B U'S
ELECTFffiJ' CONTRACTOR
Electric Servo
New 0 Change 0 T em 0
Type _ Volts _ Amps_
,
,
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT
_WH
_Sh
_Disp
_ WSoft
_ CBasin
_ San. Sewer
_Lav
_WC
_FDr
_DW
_SP
_DF
_Ur
_ Storm Sew r
_Sink
_ L Tub
_ Eject
_SS
_ Water
Other
SIGNATURE
ISSUED BY
ee Paid $ I '2-0~ ~
Date (~ '7- ~
Park Dedic tion $ {cx::9
Final/O.P. -7 --<6 ~
r
ADDRESS
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City Of Os" ash 1/1/85
Address
Owner's Name
PARKLAND DEDICATION FEE COLLECTION RECORD.
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Name of Subdivision
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Lot *
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Bldg. Pennit *
No. of Units
Fee Required
Fee Paid
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tOn
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Date
/7(1/,) Jc 1/' Aif\ {lr" j;,/l Date /
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Owner- s sigm:ture
Inspector's signature
Parks Su division
Improvem nt
Accts. R c.: 362..041
b'"2- - 57 cr- -I) 8'4? lC
State of Wisconsin
Department of Industry,
Labor & Human Relations
Division of Safety & Buildings
Box 7969
Madison, WI 53707
Wisconsin Statutes 101. 63,101.73
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WISCONSIN UNIFORM
BUILDING PERMIT
APPLICATION
ISee Instructions on back of Dink CODY)
~STRUCTURE 0 HVAC
Mailing Address r
C::--/ <P 0 W" ~ ~ IAA nll'9 r-
Mailing Address
APPLI ATION NO.t:. ~c.l?'
PARC L NO.
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ELEC D PLUMBING
Telep one
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Telep one
Owner's N7me r
<:;;;C(. b. ~ ,--";j--
Contractor's Name
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:!II~~!~!-!!!!~~I~IH!!!::...::!!;:.::.::::: )4, )4, SECTION ,N, R
BJ~~':;~S filev-e Cf..)~ I _II. dL- SUbdiVi7\~'~ uf../J ~ " C-.tk XJD Lot~? Block No.
Zoning District Lot Area I Front Rear Left Right
T2 r 9 I 7 0 Sa. ft. Setbacks ? S- ft. '"Z -5- ft. 5(Y ft. / 7) ft.
1~;~$QJeem:.':::Itt~W~11tP$. HHHHH ..$~:$ij~Ct~tQlU HH~UHVACl;Ql.,UPM~N;'t . "H H" . a~f. N$~~'$QQRC$.\.
. ~ew D Addition D Raze ~e Family Entrance/.panel !S"""Forced Air Furnace Fuel Nat. L.P. Oil Elec. Solidlsolar
UAlteration 0 Repair 0 Move 0 Two family Size: _ 0 <) amp D Radiant Baseboard or Panel jas *;,'
D Other~9"ce: D Heat Pump Space ~ tg. 0 D D D D D
D Other ~Underground D Boiler Water ~ tg. b D D D D D
D Overhead D Central Air Conditioning
1~;g~~AggHH HH H:,II:!;gg8$Ii~11;fQQNgAI'~" D Other *m?re ~ S~~:I~~ ~1~~t~~I~::: h~a~:~~we~~i~r
,gSite constructed -a-Concrete1P;pt!PMt.UNGJ'" Infiltrat on control option is: D Full sealing
D Manufactured D Masonry .~~r of join D Blower door test. D Exterior
D Treated Wood ~unicipal air infil ration barrier.
$~:$$.R.J;$ HH D Other D Septic 13.f ~AmCO$$#':l~mlW~J~alt
D 1_StorylfQ$.$.,H Permit No. "HH'HH"HHH" Envelc pe J'r 080 BTU/HR
D 2-Story ~asonal 11;W4'tSR{) """, "H Infiltra ion 2....;-O~(? BTU/HR
~:: ff:JfJJ- fjo~~;ranent [~r~~~~:~~~~~~t~eIl11;1~]~M4.P;PQQ~':'t)
/' \ -.-. $ t:; 000<::>
The applicant agrees to comply with thnWi ~nsin un~' ~L ~ . ~d ot r Municipal Ordinances and with the condi ions of this permit; understands
that the issuance of the permit creates n egalli ,e re"s o r)m DJ.ie't!, on e Department or Municipality; and certifies ~at all th~bOV nformation is
accurate. ~ /. /' ~ ,....-;7
SIGNATURE OF APPLlCA.y"'" ~'p /f:::~__/ DATE / "f /'
CONDITIONS OF APPROVAL This pe~mit is i.~sued ~ursuant to the following conditions. Failure to compl~ ~ay r€sult in ~uspension or
revocallon of thiS permIt oy..other penalty. /J /' ;
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ElorlW
ttached
D Detached
Basements ~ Sq. ft.
Living Area I z. "8" Sq. ft.
tQOO Sq. ft.
Garage
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........................................................ 0 TOWN
~~~I~II,::",,:,::,' D STATE
!~!1!!e!~I'II::: OF:
Plan Review $
Inspection $
Wis. Permit Seal(s) $
Other $
TOTAL $
SBD 5823 (R. 04/87)
D VILLAGE J3:CITY D COUNTY Municipality Number of
D INDfPf1':JDEt:JT r Inspection Authority
():1h K() ..'S~ ? Q ~ u-IR
I.~~"~~~~': ~~t~lFlaAtl~~M~
..frConstruction
o HVAC
D Electrical
D Plumbing
D Other
Munic ipality Number of Dwelling
Location, if different
::So
70
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NAME II-! triA DO? P\.. "'- "., i:r'
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DATE
CERT. NO.
WHITE -Issuing Jurisdiction
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YELLOW - DILHR
GREEN -Inspector
PINK - Owner/Agent
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f~AME G.~--I' ~..~L
LOT C- <r
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STREET NO. /,YS~ J/v~ ~
DATE (r - ~ ~ - 'S" 7
2-7
ADDRESS
8 LOCK
-
ZONE
SIDEWALK EXISTING
YES
LOT DIMENSIONS
o NoB
1/-30
BY D6-{;-
8UILDING GRADE ELEVATIONS STAKES SET AT SITE
,19 97
FEE: $10.00
Ju-.
I, the unders i gned, owner- or agent of the abOve ceser i bed property
grade establ ished before excavation has eommenc d.
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Bui1di.ng Pemit i Zo~ 1-,/ COnfo:m:Ln;_
Job Location _ fVl~ U-" ~ o:i.mansion
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GENERAL
ZOOING/r.AND USE COr.1PLIANCE CHECKUST
oming_
I.ot Area"
II. " CCNSTIU:'!'ICN DA'm
Desc:ril:le N:1rk:
~/ NE.W ~CN
ADOITICN-
CN
Pool
_ Deck/Patio
~ Sign
Porch _
_ k:c:esso:z:y Bu.i.lding
Fence
Ibathouse
_ Utility Structure
_ Other (specify)
m. <DMPLIANCE: cmx::I<S
Carclies
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~
..1L
V""
~
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\/
(/
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L
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Deficient
Use
Iot Width
Iot Area
Floodplain- .
Front Yard
Rear Yard
Side Yard (R)
Si&! Yaref (L)
Parldng
Bui.lding Area
Iot Area per Family
Comer lot
Other (specify)
REVIEti AtJI'EORI'IY
The Planning Di..rec-...or, or appropriate designee, nust approve
the following: (1) Alterations or interior or,.,ork when the use .
\Yhen. no change of use is proposed. (2) Maintenance items, e.g.
etc., when the use is confo:aning an:i when r.o chanc3'e of,.'use is.
Instances where \VOrk o::r:tplies with the above criteJ::4, ilie. ."
by the Building Inspector without refen-al to the Planning nir
~ APPPOVm NOr APProvED
IV.
Oeficiencv
:t:s
plans, except
confo~g a.rx1
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oa.......... ~ WJ..I1OOWS;t.:"
ech..
Plan Comnission Action ReqUired
variance (s) Fequired
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FIRST ADDITION TO FOX CHASE SUBDIVISION
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