HomeMy WebLinkAbout0032605-Building
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
, ID
32605
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N2
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OWNER
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PLAN NO. e I I~ O~ 93f(..;
ADDRESS
DESIGNER
USE/NATURE OF WORK
5?ALI 4~K tfff. Ak.
, .
BUILDING CONTRACTOR m..L/AA-# (!~ ~
Size ~ Sq. Ft. "1--z,..(pc, # Rooms ?r-3/34
Foundation &~ Class of Const.
# Stories --z-... Height U I'
~ Occupancy Permit ~
HEATING CONTRACTOR ~
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR #./"'~ ~
Electric Servo New 0 Change 0 Temp 0 Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR ~~~
_Ur
_ CBasin
_ San. Sewer
_ Storm Sewer
_ Water
_BT _WH _Disp
_Lav _Sh _DW
_WC _FDr _SP
_Sink _ LTub _ Eject
Other
_ WSoft
_DF
_SS
FEES: Valuation $
ISSUED BY
Park Dedication $ I () tl. tl()
Final/O.P. J/ /21/ 9..q
I /
Date
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
~
R~
AGE T/ WNER
R ~~Q. R~..
V! V&(.3
DATE
ADDRESS
;to ~ c::> S ..
c;.:T\.ClQ..M-~ >''1 b'(
l.f9 r I ~<:{ (
TELEPHONE #
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ReYise:i: 8189
ZONING:
Q-,(
ZONING/LAND USE COMPLIANCE CHECKLIST
JOB' LOCATION: 30:2 ~ jt/~ g~
l'ROPERTY OWNER/CONTRACTOR: J?1...edt~ ~ ~,
CONSTRUCTION DATA: ~EW CONSTRUCiJKN ___ADDITION ALTERATION ---pARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (Le. fence, pool, sign, deck, etc.)
Yl/!;f cJbI,~. 2-~.~><l-7 7rs's4,.k,
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEF!CIENT
I Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (frcnt yard)
Rear Yard
Side Yard (R)
Side Yard (L)
Parking Spaces
Building Area
Lot Area Per .Fami.1y
Corner Lot
Landscaping
Transitional Yard
Off-Street Loading
Vision Clearance
~ht.
RE''t~ AUTHORITY:, . ~ (jiA).i>I.Ul ~ . .
The Director of Community Development, or d~~n~,~st approve all plans. except the
following: (1) Alterations or interior work when the use is conforming and when no change
in use is proposed. (2) r~aintenance items,. e.g. sicl,ing, windows, ete.. when the use is
conforming and when no change is proposed.
Instances where work complies with the above criteria, the permit can be reviewed by the
Building Inspector without referral to the Director of Community Development, or designee.
~PROVE; DENIED
Plan Commission Action Required
Variance(s) RkJ. ...r::2- d!:~
REVIE1JJED BY/~
DEF!CIENCY/COMMENTS
----.
DATE:
~/J /9J
I 1-
Wisconsin Department of Industry,
~ Labor and Human Relations
Safety and Buildings Division
P.O. Box 7969
Madison, WI 53707
WisGonsin Statutes 101.63,101.73
E I I Z- 0 "'Z.-93 ;e,
WISCONSIN UNIFORM
BUILDING PERMIT
APPLICATION
(See instructions on back of pink copy)
Application No.
.31..IoIJ~
Parcel No.
:!il!il!I:I~II:I~li:lllllillllli.I:I.!.I:lli%constr 0 HVAC 0 Elec 0 Plbg
Owner's Name Mailing Address
CAJ /...~ ~ /~ '1..-0 Xo L. jf;.A ~; a. duL.-K /!;~
Contractor's"Name , M/iling Address /. I
/71J/~~ t~",,/~
il.I::I:.:iillil!IIIII~.li~III:II.:,i: Lot Area So. ft.
R.Erosion
o Other:
S-lf- 3(:/ ~
Telephone No. (include area code)
~"7-19<?/
Telephone No. (include area code)
1/4, 1/4, Section
Building Address il I/J.d Subdivision Name Lot No.
~;).5 I"~a.u. I~L-" /~~.~ - ~ .;t-~ ~
Zoning District(s) I Zoning Permit No. Fron) Rear Left Right
Je..- ( Setbacks "t 0 ft. G, v.- ft.:;-7 ft. 3'1 ft.
\id':PRQJielrmrrmtttmmtttwrrmttwr ra1utJ.atO,X&tift aUmltiafmGit'tmH:::!uaivA(tlifdIPMIN:Ttr::::d:IItENEJ.U~:,f5OURdf::ttmrt:t:::r:::::m:':t:t?:t\:
~ew 0 Repair ~ingle Family Entrance Panel $Forced Air Furnace Fuel Nat. L. P. Oil Elec. Solid Solar
O'Alteration 0 Raze 0 Two Family Size: 21) () amp '0 Radiant Baseboard or Panel Gas *
o Addition 0 Move 0 Garage Service: 0 Heat Pump Space Htg k 0 0 0 0 0
o Other (print): ~Underground 0 Boiler .
o Overhead 0 Central Air Conditioning Water Htg ~ 0 0 0 0 0
o Other '4.i.JCONStJlFJ1tPE'J: }l]::::F.QUNQADON': :.:~.~~:~.:::.:.:::.::.::.:.::::.....:.:.:.:.:.:.:.:.::.::.:.:.::.::.::.:.:.:: ~~e~~s~~;~egd ue7~~~:~ :;:c~ 3h:~~~~~qO~iP.
:::: .,,;;::,..::..:.. :.."'.... :.::.......:. .:......:::::;;::::::;:;;::::::,::;;::::"::: ~~:en~~~~~~~r ~~o:s~~~; :::1qBJ!~'YM.N.;t:Jt\\J::::.:tJf:? ~/;~r~t~OD~7~~~~~~~;t~~P ~ ~:::rli~(
.:.2..:.:'ARlAJNVO'tVEO:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:-:.:. ......................................... 0 Treated Wood Sewer . infiltr tion barrier
:::l)":::::St.ORIES':::::::::::::::::::::::::::: 0 0 h ......,..nunicipal air a .
Unfinished Basementl'l.../3 Sq ft ,:.~:: :'.::po. :::,::::::,:,;::,,:::;:::,::: t er B"_'" i::::::::m::1'-t:::HI~"l1i:tQ$$:::(~iJ~iib~t~Hi::ii:
. . - . . D1-Story :::8U:USE::rr:((:::::'(,:::::::::::(::: D~~~~~tNO. Envelope ..:2k"/tY't? BTU/HR
living Area ;J. 2.'" (, Sq. ft. ~2-Story 0 Seasonal .............p...P. p.. ............................................. . . .# 7 J, if LJ BTU/H R
Garage 7 IS. S' Sq. ft_ 0 Other ~~~:;nent (=:~~;~~~;:::I:~~:::J(:r::ttt:tt:( :ji~:~iJ.~JiJJUIUti::C.Q.$lt::i::ti::i:i:::::i::iii:itF::t:::
I)!I Plus Basement rd Private On-Site Well $ , , ~. 000. 0'0
T
N, R E (or) W
Block No.
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions ofthls 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.
APPLICANT'S SIGNATURE ~ R~ DATE SIGNED R/"~.3
"
APPROVAL CON DITIONS
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1'", /___" ~ "fi'
,
This permit is issued pursuant to the following conditions.
revocation ofthis permit or other penalty.
A A bo./.1 ,,/ 1lJ./~~dJ 4,0 Ar:-, "r.-:;:--:.,
. I #
Failure to comply may result in suspension or
.
., ........................ ~
.!. DTOW"OZ rty DCo""" OS"" of, M""id""rtyN;b,~fDW'~lZti"-
i~~~e~i~~w ~~ ,+0. n 0 -. g~r;:guction Name ~z.... !!Ie;. ~3 ",.
Wis. Perm it Seal "30 .0..0 0 Electrical 12- Ll 55'')--
Other 0 Plumbing T Date
~rosion ..., 5 ~O
Total $ ,0 .00 tJ~ Cert. No. .,.? ~ I
/
SBD-5823 (R.07/92)
WHITE -IssUIng Junsdlctlon
"YELLOW - DILHR I
....;+:.,:.;..:>.....,...-,., .".,-,.,,~
GREEN -Inspector PINK - Owner/Agent
<t
City Of Oshkosh 1/1/85
..
PARKLAND DEDICATION FEE COLLECTION RECORD
Address t30,p.6 /?~ ~
Owner's Name ,h{ ;.d~ ~~
Name of Subdivision ~ &1L-#~
Lot #
y
Bldg. Pennit # 2iZ-~O r-
No. of Units
(
Fee Requi red
Fee Paid
Irro.oU
.
!(K).oo
Owner's signature ~ 'K.~
Inspector's signature ~ ~~~
Date 0Vq..3
Date ~/..,;-jq3
, I
Parks Subdivision
Improvement
Accts. Rec.: 362-041
~_-=:'-'-'-'--'----:-
NAME
m~/Vn( (lLh4AJ-1-.
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LOT
SU8DIV. . p~(M2.~~
STREET NO. ... ~O 2. ~ /I ~ r?f t!JA...L
SIDEWALK EXISTING
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
FEE, $15.00
1
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CATE
2--1 rjq"3
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ADDRESS
BLOCK
~.l ABD
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ZONE
YES
LOT DIMENSIONS
o NO[EJ
~/'i ,19 &1:3
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BY krJ
~hf/if:~
. D PART~ENT OF ?L8LiC WORKS
I, the unders i gned. owner or agent of the above descr i bed proper"t"f agree "to have the
grade estabi ished before excavation has commenced.
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