HomeMy WebLinkAbout0033743-Building
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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33743
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TYPE: BLDG .Q( HTG 0 ELEC 0 PLBG 0 SIGN 0 ZONING Ie -( FLOOD PLAIN
HEIGHT
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ADDRESS
1"'1'1 .#'&-01~ 4~ ~d'
PLAN NO. E 16 7& ~"73~
OWNER
DESIGNER
USE/NATURE OF WORK ~ ~ /d'~~ tlff,Jlu.
BUILDING CONTRACTOR ,~f ~
S;ze ':>>r l Sq. F1. L.39' r # Rooms t - :3 ~# Slo"es
Foundatio _ ~ Class of Const. tf
I Height
Occupancy Permit
II-
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HEATING CONTRACTOR
13~.ut k":A
Heat 0 NC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR ~..(.44"'j~~
Electric Servo New 0 Change 0 ~emp 0
Type _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR ~ t/fr
_Sink
Other
_FOr
_ LTub
_Disp
_OW
_SP
_ WSoft
_ CBasin
_BT
_WH
_Sh
_OF
_ San. Sewer
_Lav
_WC
_Ur
_ Storm Sewer
_ Water
_ Eject
_SS
FEES: Valuation $ 30 ) 00 0 . C 0 Permit Fee Paid $
ISSUED BY ~/<it..(.I /~,,~ Date
/Os. 00
5/&/9.3
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Park Dedication $ /00. 0 0
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE Y L & 5/')93
AGENT/OWNER I OJTE
ADDRESS
TELEPHONE #
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ZONING/LANO USE COMPLIANCE CHECKLIST
JOB LOCATION: /~ '-f t/ ~~.~ ~~ LJ/(.
PROPERTY OWNER/CONTRACTOR: g~ <if !;::o'/~k--
CONSTRUCTION DATA: ~ CONSTRUcr.KN ____ADDITION ~ALTERATI0N
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence. pool. sign. deck. e~c.)
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Revisai: 8/89
ZONING:
ill
~ARKING LOT
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICI~~T
Instances where work complies with the above criteria, the permit can be reviewed by the
Building Inspector without ref~rral to the Director of Community Development. or designee.
~PPROVED OENIED
Plan Commission Action Required
Variance(s) Required ~
REYIEl/ED B~~ ~
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DEFICIENCY/COMMENTS
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DATE:
~_. .' . ..;~ POINT
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POINT
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STRAW BALES
FIL Ti:R FENCE
PROF5::;TY LINE
Df' .//1 .;~ II
,_EI67():S-93~
WISCONSIN UNIFORM
BUILDING PERMIT
APPLICATION
(See instructions on back of pink copy)
Application No. '
c.
337Y:~
Wisconsin Departrlent of Industry,
Labor and Human Relations
Safety and Buildings Division
P,O, Box 7969
Madison, WI 53707
Wisconsin Statutes 101,63,101.73
Parcel No.
i~I.I~I:.:I~.IJI~IIIIIII~ill~.III:J'III.I,111 j(constr
Owner's Name
D HVAC
DElee
DPlbg
~rosion
D Other:
Mailing Address
Telephone No, (include area code)
,
Contractor'~Name s;J /A ~4 _ Mailing Address 'I J /7 /J /) _ ,# T~ephone No. (include area code)
~.J1h#~. 'r'#'.,.A"/A.... ~A~ . "-"7(;0 W./..A~"""~A/&AYU~
111:,!:lli,j,iil~lll:illllll:JII:i:11 LotArea SQ, ft. 1/4, 1/4, Secti:n T N, R E (or)W
BUiJ~0S.L #~ ~ hh_ LJr. SUbdiViSi5;;. ~ Lot?O y:=- Block No,
Zoning District(s) Zoning PermitNo, Front Rear Left f If' Right I
,e-I Setbacks ~f) ft. (P7 ft. /7' ft, 17 ~ V' ft.
tll/pldjECt}::}}~tt:}H}:}}i~t:::}HH:trmaEiidteu."XNdYtH:fUtecrcrmtlAtm:::rtlu Hvxe::lt UlPMIRiWttflll::mER(;:vmIOURdI[ttt t:}:tmm::tm}}}}}}~
~~w 0 Repair ];OllICtingle Family Entrance Panel' l)/:forced Air Furnace F I Nat. L. P. Oil Ele<:. Solid Solar
o Alteration 0 Raze -TI Two Family Size: /(;0 amp 0 Radiant Baseboard or Panel ue Gas *
o Addition 0 Move 0 Garage Service: 0 Heat Pump Space Htg 0 0 0 0 0 0
o Other (print): f'"RI"I.lnderground 0 Boiler
I TIO~erhead 0 Central Air Conditioning Water Htg 0 0 0 0 0 0
j:u':~n'iOf:AI'n'~I"'S~h,reAd'aBNa'Ms;::e'OmteMn':::t~s}'qmm,mfttm,1 !_~S'"t~o~r:y~~I~"':":"":":"8:~'_:':"':~:':':'~:C""":'",QU,:,:",:,:~.~".O:f",:e"""""d,,,:r,,::,:.,:y""e"::,:W":.,,,:!A,,:',::',,:',::',,:',,,:'",:",:n,:",:,',o".:":':,:"::.:~.,:,,,:,,:,,,:::,'":'""":.",N.,:":'.":'",:,,,,.,:.,.:,:.,,,,,:',: t.D~p~e.etp'r~mt:tl~irt:'~N:o~,:ll_I:tm ~E:nrfv'iefl~o~pie]~~~~:~,:~7~~~B':T:a~U;:/:Hi;R.
r J . W'~~ 'Fl's.. :!'mWm:!.1~~::mHg~~Q~:~~~tijJ~tjQH'{{{
Living Area 1:37~ Sq. ft. t-Story 0 Seasonal,..".",...."............""",.,."".,."",."",,,",',", '7-ir' 2--7 Jr, c?
Garage ~77 Sq. ft. 0 Other ~:~:;nent )::i~~;~;C~;:li:~~:::r:rf:,rfrrrrr ij[4~!~!;jiiiUlijbh\.i}4.Q~T.::::::!:!i!!!:0:;:0:~:j.t:!:i!
J;)(Plus Basement 0 Private On-Site Well $ t.fo" 000. () 'L)
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; understands that the issuance of
:~;~;;::~:;~:;~:~~:~P"~ 0' ''Y: 00 'v:;;,rtm,",o, moo'''p.II,,; ,"d "rtlf"~:::'~::~:, ;O;:;~O"J;;".
This permit is iSSll~d pursuant to the following conditions. Failure to comply may res~lt in s~spension or
revocation of this permit or other penalty.
APPROVAL CONDITIONS
:::.::!lslmIN:Q:!'!::i:::.::::i::!i:!:::::::j:!:!i:i:::::! 0 Town 0 Village ,J(City 0 County 0 State of: Municipality Number of Dwelling Location:
,.....,..,....,........,.. /J J ~ ~ -, !'} ~ 6 /
i:::::~,II~~:~~Ii1~~I:::::j:::,: (//0 fJ1! ~ M -L (.L - JQ
~)i;~:,~s,,' ~ ;r.:: I;~;:''" I Z- 'ffc 0 -V :::' ~ ~ ~
~D rosion ? s.~--o
Total $ 70 t ct) Cert. No, ........_
SBD-5823 (R, 07/92)
3e,k
WHITE -Issuing Jurisdiction
YELLOW - DILHR
GREEN -Inspector
PINK - Owner/Agent
City Of Oshkosh'1/1/8,5
PARKLAND DEDICATION FEE COlLECTI,ON RECORD
Address /(0 '-f'-( ~~~ ~~. .LJ.A ,
Owner's Name .~~ f !8...fA"~
Name of Subdivision ...#ts-1c::' ~
Lot #
10 c..{
Bldg. Pennit # 337 C/3
No. of Units
I
Fee Requi red
/00.0'0
I oo..~~_ (U
Owner1s signature ~~______-
Inspector's signature ~ ~~~
Fee Paid
Date
Date S/" /q3
,
Parks Subdivision
Improvement
Accts. Rec.: 362-041
CATE
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NAME ,:~~r:~t!A
LOT I 0 <-r
:~::~'NO<%Y~,~
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ADDRESS
8 LOC K
~'l ARD
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ZONE
SIDEWALK EXISTING
YES
LOT DIMENSIONS
D NO gr
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FEE. $15.00
1?l2AM
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931
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BUILDING GRADE ELEVATIONS STAKES SET AT SITE
I, the undersigned, owner or agenT of the above described pI"'Opei~'I agree to have the
grade eSTabi isned before excavaTion has commenced.
0047~11..
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