HomeMy WebLinkAbout0042106-Building
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
1&0
N!!-42106
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TYPE: BLDG(tl HTG 0 ELEC 0 PLBG 0 SIGN 0 ZONING FLOOD PLAIN HEIGHT
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ADDRESS
QY55-OlYSt
~Cl)"e'':j
. 13LA\(E
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PLAN NO. F2-/58 Idqt.jf;
OWNER
DESIGNER
USElNA(~RSOFWORK ~ 'Dd?~1 ArrAuj!!{D 6J/Jt016ES.
rco~~\ld...::> n,f\ l~u~ E::i'\R.L'j ')
Foundation
~(~/21'Y f/o(YlES1 /;JC. . I
Sq. Ft. g~ # Rooms /a - Lj & # Stories 6? Height 9L/
eOf...)c.."'R.t::.~ Class of Const, ""i!3? Occupancy Permit -.5?~ .
BUILDING CONTRACTOR
Size I R~
. r
HEATING CONTRACTOR
~G\\)~
Heat 0 AlC D Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
C.O,,,^ \ Nb-S
Electric Servo New 0 Change 0 Temp 0
Type
Volts
Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
:I\ MS
_BT
_WH
_Sh
_FOr
_ L Tub
_Disp
_ WSoft
_ CBasin
_ San. Sewer
_ Storm Sewer
_ Water
_Lav
_OW
_SP
_DF
_WC
_Ur
_Sink
Other
_ Eject
_SS
FEES, vaJua~~~ Permit Fee Paid $
ISSUED BY. -- _ Date
Park Dedication $ &bo c GO..
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~~
AGENT/OWNER
ADDRESS
50\
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bJ&S"rh t:::-z.p
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/I--/P' -7'y
DATE
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TELEPHONE #
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ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: C)l/s-s - OYS--1 tdA~e C7:
PROPERTY OWNER/CONTRACTOR: <a:.olZ.! n/f&~ /1t.:C.
I '
V- New Construction
(i.e. fence, pool, parking lot, sign, etc.)
<S;4~ r
~? d<.-?SC}
9ID PI Z-
COMMENTS
ZONING
/l- L.=w-
CONSTRUCTION DATA:
Addition
Alteration
IT/CtIfED
f/Jo3f5
G/i~~ -?
COMPLIANCE CHECKLIST
DEFICIENT
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
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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
....~~~~~;;.,~,~-...;;._.
DATE: Ii> flo Ifj(
f I
REVIEWED BY"
F&- \S~- \D\C\q-.~
I Wisconsin Department of Industry, WISCONSIN UNIFORM BUILQING .
~:f~;/:hdd~~~;i~::~i~i~~;n PERMIT APPLICATION
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 101.63 101.73 programs [Privacy Law,s. 1504 (1) (m)].
))~p"""'En(M""i"'ArR""'<E'nflE"":::s':')r'E:':''''g''''':,:,,:;:''': I'fi1 'Constr. 0 HVAC 0 Elec: 0 Plbg '~Erosion
~tt~L:~~~E2L::::::A\ti~j:::~::L)$g~::::~;;:~::}tL:/:;;;)ti!tj ~' ., \~I
own~~ec~ltl1j ~ IM:';~~ess N
Contractor's Name: n.e6n 0 Elec 0 HVAC 0 Plbg LicJCert # _ Mailing Address
.7 5 K-o rzjQf
Contr'actor's Name: 0 Con )2I'tlec 0 HVAC 0 Plbg LicJCert #
r LJ'J YYl 1 ~ 1"..<;
Contractor's Name: 0 Co~D Elec lA"RVAC 0 Plbg LicJCert #
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Contrac;tor'sName: DC~, J~~D HVAC IZI1'lbg LicJCert #
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Zoning District(s)
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Application No.
4~ VDf::,
Parcel No.
o Other:
.
::!I}:"'Jlct::m:}:t:it::::f:t:: :'::::. ::::::i:::
[.;I1I,Jew 0 Repair
15 Alteration 0 Raze
o Addition 0 Move
Telephone No.
( ).y~-Zt!JD1
Telephone No. .f"
( ):2:?/ -/1., Y'
~~lep~;i~W, .
~ele~h'~p~8~VPcJ
Telepho:~.
(~ "r?-?~3r;z..v
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1/4,1/4, Section T N, R E (or) W
Subdivision Name Lot No, / / Block No.
a~rn",J'.I'O' 6671Ht4 ~ T
. Front I Rear Left Right
Setbacks :}O ft. ~ ft. / tf. S- ft. IV. r ft.
:i'if~O(<lUPAN(iY;~iii.Flij~mm.Uii;in~~UJiVAai~QtnPMe.N1Wttii:dlnii'N!RG~j:iiS.OOt(tljirt:i::ii~:ri:;i~:rr:i:ri~:rrr:i:
gj.i.ngle Family Entrance Panel @!':orced AirFurnace Fuel Nat L. P Qil Elec Solid Solar
.J2I"Two Family Size: _~ amp 0 Radiant Baseboard or Panel Gas *
o Garage Servicr- 0 Heat Pump S ~ 0 0 0 0 0
o Other (print): ~derground 0 Boiler pate Htg..A:J .
o Overhead 0 Central Air Conditioning Water Htg..zr 0 0 0 0 0
o Other )1M:'QNS.TfrrvPEtlTfQUNQAllo.R:i~ 0 Other ~~~~s~~:regdUe7~~~:~ ::avc~ 3h:~~~~~qO~iP.
ZPARiAJJNVQ4VIQrirn:::::::: 1i~:en~~:~~~~~ded I ~~::~~J Wood :i:~~~.~:::::~tgM'JNG.::'r:~:~tI~:~::::;~:::~~~::ir ~:J2~i::fi~7~:~I~~~~; t~~P ~~:::rli~(
-I.$ce,iSGstoltIESirriitijij DOthe j2'Munlclpal
Unfinished Basemen _ Sq. ft HD1_'~~~r~HHHH'H"'aUUs.t:iii:::ii:tttiit:rimi:i 0 Septl~ .'. ::::i:::i~::m::j:!f~~::::iHlijji~Q$.$;::itmi~~q~~\"ijliii~i~j~ii~
~:~~::'e' o?:,:t ::: ~~~;'~~:i:L: ~~~~m_nl;~
J2(Plus Basement 0 Private On"Site Well $ 90 " ~ . .
The applicant agrees to comply with all applicable codes, statutes and oidinancesand with the conditions ofthis permit; understands that the issuance of
the permit creates no legal liability, express or implied, on the Derl ent or municipali~; and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE ~ /' J ~ - .i DATE SIGNED / / -/ if) - 'j y
.
W<;tSn:::/~L..D
'ST.
.
Mailing Address
Mailing Address
Mailing Address
Zoning Permit No.
APPR OVAL CON D ITI ON S This perm it is issued pursua nt to the followi ng conditions. Fa ilure to com ply may resu It in suspension or
revocation of this permit or other penalty. .
J,,) IP5TAu.. S'0lL.. ~a:xv rnE~Su~ . x:::r(.. lLHR. OI.las.
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.
.; 0 Town
o Village .~ City 0 County
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:::::::::::::RfdVU':tt$f::::::::
'::~i:~::::!$~Y~P::;i?,:::.ii::i
o State of:
Municipality Number of Dwelling Location:
"?-o-c)66
Plan Review $ to
Inspection $
Wis. Permit Seal $ -aD
Other $
Total $ ?o
Rcon. struction
bHVAC
o Electrical
o Plumbing
~rosion
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Nam: K~ ~
lD\ iD\ q,-\
YhDg>
Date
J 5d 305
Cert. No.
SBD-5823 (R. 06/94) WHITE -Issuing Jurisdiction
~ (OM;::i/(. n-b
YELLOW - blLHR I
GREEN -Inspector
PINK - Owner/Agent
CATE
/0/7;;7
I (
SIDEWALK EXISTING
NAME ~';;:ec-~ ;..J-y ~
I
LOT .y 8 LOCK
SUBD I '1.~S:~~,,- 'f>::x~r:fhZONE
s~rer~o."'...<9'~ . ti'/a..ke 6t- LOT DIMENSIONS
YES 0 NO [;~r
I I;) //0 ,1994
, I
ADDRESS
',.iARD
8Y /L,J
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
FEE ~ $15. 00
I, the unders j gned, owner or agent of the above descr i oed proper'!", agree 1'0 have ~he
grade estaD j i shed before excavat i on has commenced,.
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City Of Oshkosh 1/1/85
Owners Name
PARKLAND DEDICATION FEE COLLECTION RECORD
d~ 55 - ~s:t- BLAKE CT:
__ SECbLC~"j t-\o~CSI l~.
Ch.:.I0R'f3,u:>{E ES:\l~TE:.'S Nok-l1{
Bldg. Pennit # y& l Db
Address
Name of Subdivision
4
Lot #
Fee Required
Q
-4 at()
4t &to
No. of Units
Fee Paid
~~
Owner's si gnature - .. Date
Inspector's signature ---. - -. ---.. . Date
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Parks Subdivision
Improvement
Accts. Rec.: 362-041