HomeMy WebLinkAbout0001217-Building
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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
01217
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ADD~:~S / '1.'c; O~?#;q~ Cr . PLAN NO. {J4--S-S2t-Bg.~;t.
OWNER jJJ~t9?tj ~~ bA-t,G ~k;vse.fI -5;;J.D $oPLJ ~
DESIGNER SG;jJ~ PLA jlJ :5G!2-iI/~
USE/NATUREOF~RK J.kw $(p~ug f'4#/i-'r' kL16"uce: LeY A-~ ~Z
t;4t1-fltpG, (!.o ,N"LJ/'lJ c;/J;' U05 S f?t' ~ eS'UA--<-v ~ I" $>> I!!5U I ~~
~/OIL oz; ,7;1'J:.rt-./er1f7C1 / . :
~r./ '7~#lP 4,141 26/ ~:a'1 / ~;(P:# /4./ ~~ g ~
BUILDING CONTRACTOR (/!;4j)f4f (J1ff~ /1/3 O~r-l 5r- -2~~~
Size ~. Sq. Ft. ';;1,,;2- ~ '" . # oms <g't-..;L h4rHS # Stories t3/t:eut:.L Height it; ,
;tK-PV/:$ re;;:.e.S'otr..J · /7
Foundation 1Ji/.. - t:? ~ ( . Class of Const.:!? Occupancy Permit /-<~Uf/Z&:J
;< -1Ae.7P tz~ tv~ 19 f!l?IL./~ 32$ 11J1JV';;(J:;fL" ~5- fbll",v ~ S-
HEATING CONTRACTOR t!&,v.(J,??,c..J t:G~##-'
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELEC;RIC CONTRACTOR e V~).4 I JJ6.s
Electric Servo New 0 Change 0 Temp 0
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
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_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _DW _DF _San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ L Tub _ Eject _SS _ Water
Other
/
1010 Permit Fee Paid $ 9& .,::E- :v/
Date 9-6 -f?
Park Dedication $
Final/O.P.
IUD
ISSUED BY
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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TELEPHONE #
SIGNATURE
ADDRESS
'1- .....-'"':~~
.._NAME~~!~ ~
f, 'I'" -, , ' ", ,-
'LOT ;;;...~
S6BDlv6~~~. fA~
STREET NO. /730 O/lGU/J(lfj Gf
ADDRESS
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_icW ~ ;.Y--
HARD
I
DATE
BLOCK
ZONE
SIDEWALK EXISTING
YES
LOT DIMENSIONS
D NOg
q-s
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
8"
, 19 . ""
BY I~,J
FEE:
$1hOO
r)~~ 1-4 #f?
G,~~~
DEPARTMENT OF PUBLIC WORKS
I, the undel"'s i gned, owner or agent of the above descr i bed property agre~~a've the
grade eSTabl ished before excavation haSJC~~
f?:JS:J9?ft~e
:: PeI:mit # Zonin:Jk ~~~~_ ~nfoming_'
Job Ilxation /13q V,tet/{J,1-t1 f2t- Lo~ Dimmsion
property Owner 1~t2#tD{ ~46/i1P.5C#-. Lot Area. .
II. . a:NS'l'Ittrl'Ic:N DATA
Describe ~: )/uu ~P;a-f-A-T7..v~J G~~b
t.
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ZCNING;r.;;.\j1) USE CONPUANCE QiEQcr..IST
+bmW.~CN
_ Accessory B'I1i1oirq.
Fence
Boathouse
Utility St1:1Jctm:e
-
_ Other (specify)
m. ~. c:::E'.Cl:KS
CarClies Deficient
V
(//
~
7
Y
/
J
~
7
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"7J/1r
-
...........
...........
-
'. JWrEAATICN
. 6 $fii(jle' Family,
'l'wo-Famil:
- ,,~.
MiIti.~FamU
- .'!
_.~.
_~Ufa~
, I
ADDITICN';'
Pool
_ Oeck/Patio
~ Sign
Porch .
. ,
!
. Deficienc:v/Catm!nts
Use
Lot Width
Lot Area
Floodplain -
FJ:ont Yard
Rear Yard
SiCa Yard (R)
Side Yard (L)
Parking
a..,-n dtng Area
Lot Area per Family
Comer Lot
Other (specify)
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IV. REVmi AtmiOIU'!'Y
The Plarlning' Director, or appropriate designee, must approve all plans, except
the fo1low.i.ng: (1) Alterations or interior work when the USe is cxmforming arxi
when no change of use is pz:oposed. (2) Maintenance items, e:.g~;'" ~ wi.n<:boJS:r;'
etc., Wen the use is confo1:Ining ani when IX) ~ of.'use is. pmposed.....
Instances where wo~ o::nplies with the al:xJve cri~iaJ" tfie.. ~ '~.'l:e revier.-.'ed
by the Building ~r without referral to the Planning Dire<:tbr'.~ ..
- . APProVED ,NOr APProvED
Plan Conmission Action Required
Variance (5) F.equired
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City of Osh~osh l/1/B5
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PARKLAND DEDICATION FEE COLLECTION RECORD
Address / 730 tJ~~-/J e!f-
Owners Name ~/!Cg,c;l GA~ ~/V~5LJf
Name of Subdi vi si on DzeifJ4tJ-t1 /AVre:: ,Zf:v~~-5
c=-. "
Lot If dS- Bldg. Pennit , Jd-/7
/
No. of Units /
Fee Requi red~ / t1 ?J
Fee Paid j / tlt) . . . .~' ......... ...
Own~r's signcture .~~ If a~te '11~/X'6
Inspector's signature ' Date
1"'--
Parks Subdivision
Improvement ,
Accts. Re.c.: 362-041
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 C- 4--
BUILDING PERMIT APPLICATION NO.
APPLICATION sr4-ggb~
(See Instruction on back) PARCEL NO.
DPLUMBING
Telephone
,T
Lot No.
;;zs-
N, R. E(or)W
Block No,
.-
Right
Basements
Living Area,;;l/4
Garage4f5 4-
The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Muncipal Ordinances and with the conditions of this permit; understands
thaSfhe issuance of the permit creates no legal liability,"e press or implied, the D ent or~uniciPality; and certifies that al the bove information is
SIGa~ATURE OF APPLICANT ~- DATE ~ b
CONDITIONS OF APPROVAL
This permit is . ed ursuant to the following conditions. Failure to comply may result in suspension or revoca-
tion of this permit or other penalty,
DCOUNTY Municipality Number
Municipality Number of Dwelling
Location, if different
Plan Review . . , $
Inspection. . . , $
Wis. Permit Seal(s) . $ ~
Other. . . . . , . , , $
TOTAL, . , . . $
01 LHR-SBD 5823 (R. 11/84) WHITE - Issuing Jurisdiction
Construction
VAC
"Electrical
Plumbing
DOther
NAME >>.
{/
DATE
"0
4~:r4~
CERT. NO,
~I 0 4=-
YELLOW - DILHR
GREEN - Inspector
PINK - Owner/Agent
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