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CITY OF OSHKOSH N2 00955
PERMIT - APPLICATION AND RECORD
l'tPE: BLDG~.rnG D ELEC D PLBG D SIGN D ZONING /2--3 FLOOD PLAIN cnvrHEIGHT#( D4
- - - - - - - - - - - - - - - -, - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
A~DRESS 1%7-0 a.e.f/tf4M U).Je7PLAN NO. tJZ'~S40-88~1:.
OWNER )-1/ef-/A-!3L. _5(/55 /G:z-Cf Caur/44t- S-r 4U - ~~3;;ZS-
DESIGNER r-5c€tJ/-fcJJ c:;:,/LI 135 ,./ Z:~7 5tP (!t:?~~//I-L. __' p~ 7.?J.;L - d-4-4S--
.
..~. ~~E/NATURE OF WORK A/~ ~ijJ~/E P/JJ.4{L.~ ~ t<.YA~LJ 6A~e:F- "
ii.-:DI1-9(J/\f10P: (j) 77Loss PtA-JJS Lu( LL i!;G $tJ;$.J.1{'"('t'"'E:() jJd/tJ/'L 'TV
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JfJr trt;Cl U? P.zc;- /Z S7 1. /1,.5- jLl,b
BUILDING CONTRACTOR ~6(L.. /-14.~'tb 40Q b l-/r.{ W Y z/ 4 Zfo ..... ~3..3
Size~{..AIL Sq. Ft. Ir;:.r b # Rooms ff:..!3!'lt(fl5 # ~tories d- Height ~
FOUndatiOn;';",~ ~~HUrl-l- Class of Const. ~~Occupancy Pe,mlf c>. .
FI;!e(l./aP: w.~c; 1-4:!iS tt (3 / {l;IL(/JC::. /2. 38, ~> bl1. RS ifmJLWL ~S
HEATING CONTRACTOR ~ -~/JfJJ6!2 ~/F/1
I
Heat D NC D Vent D Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR (]LHPf/ ))65
Electric Servo New D Change D Temp D
Type _ Volts _ AmprLtf (J
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR /::':;;:'!f /.!,to5
I
_BT _WH _Disp
_WC
_FDr
_ L Tub
_Ur
_ CBasin
_ San. Sewer
_ Storm Sewer
_ Water
_Lav
_Sh
_DW
_SP
_ WSoft
_DF
_Sink
Other
_ Eject
_SS
/
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FEES: valua!lr $ {/.?-l./ (/( --< .-/ Permit Fee Paid $ I ~ · r---.
ISSUED B~ e-"" Date ~ -/ 1 -<f~
Park Dedication $ 100
Final/O.P. ~ CL(c?!}'?
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURe! ~ c/~ )T 12-
0:6
DATE
ADDRESS
TELEPHONE #
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t't
ZCNING~"""D OSE m1PLIANCE: <:::aEO<US'l'
t.
G.ENERAL
Build.i.nq Petmi.t t Zo' jl:3 COnfo' Non-Confo' .
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Job !J:)cat:ionlP4./ ~J b-J. {:~ "or, .1 \V"'- tot DiItension
I
Prcpert:y Owner M \C~A/,[L SU~Ss: Lot: Area
II. . exNsrntCTICN ~
0esc:ril::Ie tm'k: }J fLw ~u:; ~ &00
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A -r.-'(ACi....\ fEfj ~{J ((A-Cdt-
X NDl~
AODI'rICN-
: AUr.'ERAT:t~
_ Accesso%y E3l'~ 1 din;
Fence
Boat:house
-
_ Otility Structure
_ Other (specify)
: ~$lhqle' Family"
"l'wo-FamiJ:
- " If:.
_ Milt.i.~Family ,
-~.
--~~
'.
Pool
Oeck/Patio
-
. Sign
~
POrch, .
In. ~ CHEX:l<S
CarDlies
. c..,,-/
DeficiepcY /Cc:I'mIt!nt$
-
v
-
V
v
~
V,
-
V
V
-
V
V
V
7;J/~ .
Bni1dinq Area
tot Area per Family
Corner Iot
other (specify)
IV. REmEti At1mORm'
The Planninq Director, or appropriate designee, ItDJSt approve all plans, 'except
the following: (1) Alterations or interior \tlOrk when t.~ use is confortning .arXi
when no change of use is pro;x:>sed. (2) Maintenance items, e;.g.;;,-~ wi.ndows:t;"
etc., when the use is confoI:Ining arx1 when IX) chan<Je ot\~e is. propaaed.;...
Instances where wo.1:k o:nplies with the aI:ove criteia.al' trie, ~ "~,l=e revie".'ed
by the Building Inspector without referral to the Planning DIrectbr';" '
~ 1lPprow NO!' APProVED
Plan Corcmission Action Required
variance (5) Required
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State of Wisconsin
Department of Industry,
Labor & Human Relations
Division of Safety & Buildings
Box 7969
Madison, WI 53707
Wisconsin Statutes 101,63,101,73
WISCONSIN UNIFORM (!..;J..
540 -i/,g t.;'i..
BUILDING PERMIT
APPlICA TION
9:SS-
APPLICATION NO,
(See Instruction on back)
PARCEL NO.
~STRUCTURE ~VAC
Mailing Address
llc. '-4 CEA.rr~<- $"l r
LEC DPLUMBING
Mailing Address
40Gi 8 \.\v..s 2..l
Telephone
4- 2.-<:.- Z '3 z..';-
Telephone
4 z...~ _. ;l. 6"3 3
Yo
Yo, SECTION
l ~, . 1:>t:MJ ~JI.A
PU~ \"
Front
,T
Lot No.
~e'L
Left
17'/7-
N, R, E(or)W
Block No,
Right
Living Area
q~B
I ~q f.o
57~u
Sq. ft.
Garage
The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Muncipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no legal liability, express or implied, on the Department or Municipality; and certifies that all the above information is
accurate.
SIGNA TURE OF APPLICANT
CONDITIONS OF APPROVAL
DATE
1I0wing conditions, Failure to comply may result in suspension or revOca-
DCOUNTY Municipality Number
Municipality Number of Dwelling
Location, if different
Plan Review, , $
Inspection . . . $
Wis, Permit Seal(s) , $
Other. . . . , , . . , , ,$
TOTAL, . . . , , . $
01 LH R-SBD 5823 (R. 11/84) WH ITE - Issuing Jurisdiction
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CERT. NO, .;;;l/ 01-
YELLOW - DILHR
GREEN - Inspector
PINK - C!wner/Agent
L 07 ~ ~
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MATHWIG'S NEW HOME CONSTRUCTION CO.
4098 Hwy. 21
Oshkosh, Wis. 54901
(414) 426-2533
"'r" 55~'
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DATE
GU~vST \3 i \q66
\ ~ '2.L\ . Q (<JJ TRA L 87,
I~
~'JARD
NAME M I C h\/~EL. Stitf3..S $
LOT ~/;;L.
I; FLo.I0~ \-\~~- (S"[ Abt.>..J
sueD I V. 'k'l2AJE.G.M... {-1.AT
STREET NO. /8)", 0 C I' c.. ~ a. r d....
ADDRESS
SLaCK
ZONE
LN LOT D I MENS IONS' eq ~ (x 1;2.0 I
YES 0 NO [8J
0-13 ,19~
SIDEWALK EXISTING
SY~
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
FEE:
$lO.~~
DEPARTMENT OF PUBLIC WORKS ~ 8.
I, the undersigned, owner or agent of the above described property agree to have the
grade eSTabl iShe~::~~xcavation has ~ c~
??/" ~ . ?';':';:'K <)
a..~~
City of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /5dO {/~J~
, .." .. .." .." - '" " ..,.... I
Owners Namt! ~ ,~
Name of Subdi vi si on /:;..r- ~A (J / / . fioM- l& &f-I.-/ I ~u {%~
Lot * d d.-Bldg. Pennit , P.s:s-
No. of Units ~
Fee Required ~~
Fee Paid ~~
{
Owner's signcture Date
Inspector's Signaturtl ~ Date
Parks Subdivision
Improvement
Accts. Rec.: 362-041
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WINNEBAGO COUNTY HEIGHT PERMIT
L
CITY OF OSHKOSH
# 101
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OWNER:
ADDRESS:
TELEPHONE:
4 'Z-.Co - L.:~ 7-C;--
ADDRESS OF PREMISES AFFECTED:
I 8 2.-0
OfZ.~.J..-1t:,J).J"::~ ~~N ~
HE I GHT OF PROPOSED STRUCTURE ABOVE GRADE: ~ (0
COUNTY USE ONLY
APPROVED:
YES "t:;5)
,,/
'770 //175(--
CgOf/"n -
CJ~( . c~L
NoD
EXISTING GRADE ELEVATION:
MAXIMUM ELEVATION ALLOWED:
COMMENTS:
CITY INSPECTOR:
/"-....
lZ\~\JJ,t:J~() ~ r /v\(?J'lL
TELEPHONE: 23 \0 -<;04'[; ",/DATE :'8-/0- 8 (.,
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COUNTY INSPECTOR: .~;~p(/ 4' //1/ . 1/1> , . ,/";/.t. 'J ~
/ f' --, // ;, d IJ" : i ~ v~ E / l /"'
TELEPHONE: c~9 <;-(5:1 (Z)("') DA4E: o-/5-t--~/)-((,
Wh i te copy - County; Yellow copy - Town; Pink copy - Own.er
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NOTICE
Iff}() acLv..) it"
SECTION 7-32 CERTIFICATE OF OCCUPANCY TO BE ISSUED
The Building Inspector, Heating Inspector, Plumbing Inspector,
and Electrical Inspector shall make a final inspection of all
new buildings, additions, and alterations. If no'violatipn of A
this Chapter o.r other laws o..r 18;wful ..ord.ers. be found, .the Chief lr..r/fJ. fj\t.
Building Inspector shall issue a Certificate of Occupancy, ,~vL~V,
stating the purpose for which the building is to be used, also""'.. /!~i~/ 0 t
the maximu.m load and. maximum number Of. pe. rsons .tha~ m~y acc- 'l..-k../v.'.. ,. ~.....;. \
omodate on each floor thereof and also that the bm.ld1.ng or .If), /J.fJ'-' dn.
premise or part thereof and the purposed use thereof ~re in '\,J)v .1 L/~'-'f
conformity with the provision of Chapter 30 on Zoning and il}, \-- '\
Cit.y Plann1.'ng, as. re.quir e.d b.y sec.tion 3.0.-27 (C) of. sa1."d C. ha.Pter" .~r..."..,.,..
NO BUILDING OR PART, THEREOF SHALL BE OCCUPIED UNTIL SUCH "- 'J
CERTIFICATE HAS BEEN ISSUED" NOR SHALL ANY BUILDING BE OCCUPIED (I
IN ANY MANNER WHICH CONFLICTS WITH THE CONDITIONS PUT FORTH l
IN THE CERTIF ICATE OF OCCUPANCY.
(A)
PRESENT THIS CARD
FOR OCCUPANCY PERMIT
Code Enforcement Divisi
Room 205, City Hall
Oshkosh, Wisconsin 5490
TO
THIS BUILDING SHALL
'NOT BE OCCUPIED UNTIL
FI NAL INSPECTIONS
HAVE BEEN MADE AND
THIS CARD S I G N E DB Y
THE FOllOWING IN-
SPE CTOR'S
BUlL D I,N G
E LEe T R I C A LV)
HEATING~/?~ DATE
PLUM BIN G }~?~J[) AT E
*FIRE DATE
ROUGH PlU
APPR~
City of DA
OSHKOSH 'N~
"IT' .' ,- '",:,~,.,,",,>,~,_
, 'RDil;T'""""~7'- ....
...... . SHELl
r::J~>. f
~..ty of
OSHKOSH
~_''''~',^'___.k:'.._.:~,;..
...;!..,.,.;,^._'.~..;;,<-',.,
INSPECTIONS MAY BE
ARRANGED BY CALLING
236 - 5050.
DA'TE
DATE
* NOT APPLICABLE TO 1 AND 2 FAMILY DWELLINGS
1-7-'lJ
2-1-7;
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