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'- ~rz; y: 13 r SIDEWALK E;I ST I N~ -YES ~ NO 0 BUILDING GRADE ELEVATIONS STAKES SET AT SITE ,19 BY FEE: ~O.~ ~, ~ ~~ DEPARTMENT OF PUBL I C WORKS ZONING/LAND USE CONPtIANCEcaECKtIST GENERAL Building Permit i Zo~U Confonning_ Non-COnforming_ Job location '/9.:23 r:du6~/i.LJ ~ IDt oiIrension Property Owner ~~5 )-b(;/,v(b IDt Area II. CCNSTROCTIOO DATA ~ Describe rbrk: ~4...J"$>;-Jc;. Le;; '~~rc-(r- ~s . I. !.~ + NEW COOSTRtK:nON' _ Accessory Building Fence Boathouse _ Utility Structure _ Other (specify) III. OJMPLIANCE cm:c::KS ADOITICN ALTERATION Pool DeckjPatio ~ Sign Porch ~~ing1e Family _ Two-Pamily _ Multi-Family Cctnrnercial _ Manufacturing . Conp1ies Deficient V Use Deficiency/Carments ~ (...../' \r c----- v/ V /......--- ~ ~ ~ ~ _1V IDt Width IDt Area Floodplain _ Front Yard Rear Yard Side Yard (R) Side Yard (L) Parking Building Area IDt Area per Family Corner IDt Other (specify) / IV ~ REVIEt"1 Al7l'HORITY The Planning Director, or appropriate designee, must approve all plans, except the following: (1) Alterations or interior \\Ork when the use is confonning and when no change of use is proposed. (2) Maintenance items, e.g., siding, windo.vs, etc., when the use is confonning and when no change of use is proposed. Instances where work o::rrplies with the above criteria, the pennit can be reviewed by the Building Inspector without referral to the Planning Director. ~ APPROVED NOr APPROVED Plan Comnission Action ReqUired variance(s) Required ~~/l11~ DATE : ~6- ~ ... State of Wisconsin Department of Industry, Labor & Human Helations Division of Safety & Buildings Box 7969 Madison, WI 53707 Wisconsin Statutes 101.63, 101.73 WISCONSIN UNIFORM BUILDING PERMIT APPlICA TION ,;)55'3.r APPLICATION NO. (See Instruction on back) f}f("D:.L! PARCEL NO. ~HVAC ,.P(ELEC OPLUMBING Telephone ,T Lot N?;- Left " b N, R, E(or)W Block No Livi ng Area Garage YPtfl,/€ 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 liabilit , eXP~lied, on the Department or Municipality; and certifies that all the above information is SIGNATURE OF APPLICANT " .. . cS -- DATE 41 -// r0 CONDITIONS OF APPRO V AL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revoca- tion of this permit or other penalty. ., OCOUNTY Municipality Number Municipality Number of Dwelling Location, if different Plan Review. . . . $ Inspection. . . . $ ~J Wis. Permit Seallsl . $ ...:;;)-0 Other. . . . . . . . . . . $ TOTAL. . . . . . . $ DILHR.SBD 5823(R. 11/84) WHITE - Issuing Jurisdiction onstruction VAC lectrical Plumbing OOther 31~(4- 4 --/I-r3& CERT. NO. Z I tJ '-I- , YELLOW - DILHR GREEN - Inspector PINK - Owner/Age,..- ------- ,. l ~. .;" So.Q' \iJ "\l It ~ 'i - ----.~ 'IV I.(, '-( "" ~ .J \l) , I S f" f . 't' ,:,' .",~;~ \ ()l .1 ~; ...., ~ "I- '- -""'2>'- I" I I -t t ~- I r<;'- ---1 I . \-t i I f ' I : IJ [,-r"p Ir,:.". . 12 ,,~.i 'f :,. !r~ " .c....."...",...'.. .. .... t-o':-n . .' .'" lie v;' Ii.. .. ~ -J , I ~ ('07 .;til:_<!_L1:i,d_E:....-_~_ gl,) 60S {/~'1""'(--' ;t::,yc. ._-,- I.Z:J..s:1_/::lv..il.IJ. 8 R f;i_'"'T.__.. -----._-~,...--".,..__.----_...~-~...---- ." I '" ' . ---fl'::t~:--- ~ . 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