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Home My WebLink About0022034-Building ~ CITY OF OSHKOSH N~ PERMIT - APPLICATION AND RECORD 22034 ~-TYPE: BLDG;g HTG D ELEC D PLBG D SIGN D ZONING 1Z-! FLOOD PLAIN HEIGHT DESIGNER /7~2- #~ /t/~ ri~.#f~ USE/NATUREOFWORK >7~ /f/Z a::t:t~ , - PLAN NO. Gj' (JUt 91 If- ADDRESS OWNER BUILDING CO. NTRACTOR - ~ 4fi(h &'~" 9A&- I'.- . - BEtS 2.-I3A'TH Size \:,_ #' Sq. Ft. :27 3 ~ # Rooms I I . # Stories Foundation ~ Class of Const. f- G.-- Height:;l 9 I Occupancy Permit Re.g HEATING CONTRACTOR ~ 4..u.d.:-f ;(~I' Heat D NC D Vent D Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR ~~r Electric Servo New D Change D Temp D Type _ Volts _ Amps_ Fixtures _ Switches Receptacles Circuits PLUMBING CONTRACTOR 7tJ ~ _BT _WH _Disp _Lav _Sh _DW _WC _FDr _SP _Sink _ L Tub _ Eject Other _ WSoft _DF _ CBasin _ San. Sewer _Ur _ Storm Sewer _SS _ Water Permit Fee Paid $ Date / 380.00,1 I /1'-/ /11 f , Park Dedication $ / t1 ~. tJ tJ Final/O.P. t.,~f/'1r ISSUED BY is work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE / ~6ff/ / DAtE ADDRESS TELEPHONE # . i I I J j 1 " JACK GRIFFIN BUILDERS, INC. 10 Hilltop Court · Appleton, Wisconsin 54915 . Phone ~14j730-2988 t GA-RME <6/?) LlJT :if 5/ Pi) X t. If ItSE D!;,Hk'o~1+ LV (5, I .J//71 <>f -KJIll H~6NEl( /7lf2-- !I~ "~~\. b1.1! I I ~ ~ Fll?Sr hOOR /55b .s!;'{;()I!/.!) fJ."'t:JR //1'6 r:;}1.3-'/- LJ \ ~- /) I / \ // \ i \ I ~@,\ \ i . .-..~------- -- '30' ZONING/LAND USE COMPLIANCE CHECKLIST J€)B COCATION: / 7l/z-1f'~tlJ4 ;ff/'dS( :tx t!AL4U/ PROPERTY OWNER/CONTRACTOR: )I~ r?G~ IA(~ CONSTRUCTION DATA: ~W CONSTRUCTION ___ADDITION Revised: 8/89 ZONING: j2 -f AL TERATION PARKING LOT TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.) . ..'>1~. -!</~ az:r~ 7~?z'?r COMPLIANCE CHECKLIST (Check only those applicable) COMPLIES DEFICIENT Use Lot Width Lot Area Floodplain Front Yard Side Street (f~yard) Rear Yard Side Yard (R) Side Yard (L) Parking Spaces Building Area Lot Area Per Family Corner Lot Landscaping Transi tional Yard Off-Street Loading Vision Clearance / Height . L I. REVIEW AUTHORITY: '; (..../ ~,,~ ~/ The Director of Community Development, or designee, must 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) Maintenance ltemsi e.g. siding, windows, etc., 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. V:;PROVED. .. DENIED Plan Commission Action Required Variance(s) ReQU~~ _:7" L ~ REVIEWED B~CZ:;- DATE: ~7'1 DEFICIENCY/COMMENTS ~ Front Rear S . ft. Setbacks 30 ft. "7 !' 1iiMl'fRQJ.$4!t::dijmmj:tI:'::': :~~::1WiI.mm:mj:':i ]U$.,..c.t..tc.~:'''~'HV4Qn~QtO.M..Nt J>l Forced Air Furnace amp Er Radiant Baseboard or Panel D Heat Pump Boiler Central Air Conditioning , D Other State of Wisconsin Department of Industry, Labor & Human Relations Division of Safety & Buildings Box 7969 Madison, WI 53707 Wisconsin Statutes 101. 63,101.73 .................. ................... .................. ................,.. ................... .. ....... ........... ......... ........ .... ... . .................................................................... ,lllpl~:~~II~~~:!":,:,,.,., .................... .......... ......... .................. .. ............ .......... ..................... ............ .......... ........... .. .... ... .... [S(I New D Addition D Raze 12{(' Single Family GAlteration D Repair D Move 0 Two family D Other G I D 2-(J/9 I ;e WISCONSIN UNIFORM BUILDING PERMIT APPLICATION 'See Instructions on back 01 ink co APPLICATION NO. 22 0 :. f PARCEL NO. STRUCTURE Mailing Address D HVAC D ~ ;tj;., 730 -z-qtfr ELEC D PLUMBING Telephone Telephone %, Subdivision Name %, SECTION N,R Block No. E orW T Lot No. '5>( Right / I.f- ft. I if' mj"jj:~;:$...RhV:$QUaQ$.i.."....,."...... Fuel Nat. L.P. Oil Elec. Solid lar Gas * Space Htg. D D D D D WaterHtg. D D D D D * D Dwelling unit will have 3 kilowatt or .. more installed electric space heating equip. :ttt: Infiltration control option is: D Full sealing .......... of joints. D Blower door test. D Exterior air infiltration barrier. Left ft. ft. D Other Entrance Panel Size: .-::2tJ D Service: jgf Underground tJ Overhead ...... ..... il:IQIlmTfPI ttt:fQ'NRlllQI Concrete Masonry D Treated Wood :i!:!\)S'...;,r.~I.e'~{ """"" D Other :::~":::::::-...::~:~.~~::: 1~;:ii~4.JJlgg:' .. Attached D Detached ~ Site constructed ";j'i{"""'iIi"&e'A"" ........'.'.'.:.".'.'.'.'.'.'.'.'.'.'.'.'.'.'.'.','.'.'.'.'.'.'.'.'.,.'.'.:.".'.'.'.}' D Manufactured :~~:~:~:~"n~~~{:::::::::::: ................ ...... ..... Basements / S- 57 Sq. ft. Living Area ;). 73 S' Garage 7 c:, (c. D 1-Story Sq. ft. ~2-Story Sq. ft. 0 Other The applicant agrees to comply with the Wiscon' n that the issuance of the permit creates no Ie Iliabili accurate. S~NATUREOFAPPUCANT CONDITIONS OF APPROVAL ~/, tl f ~~ ~3.oi ) 0- il~iU$$.II:::.:I ...... ... joL1.'010M11I6: .......................-.............. ~wer ~ Municipal D Septic Permit No. 1:;U:H.IT't.0$$:Ciil~UJ~~ijfI:.'/ ........ Envelope 7o.t><f9 BTU/HR """"":?):{,):,, Infiltration .;)0.3 3 S; BTU/HR ................................................. .........,........... :1IE:I$.m;]~U~tQ..$ll:,rH.... It. D Seasonal I8t Permanent D Other Municipal Utility D Private on-site Well tlll ," 0 $ DATE . permit is issued pursuant following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty. ~ ........................... . .. . .............. '.... ............ ..............: D TOWN :ISS.UIN(I')}}}}, ....aURlsg.;;U,.::..'.,.:,' D VILLAGE Plan Review . . . $ '/0, () 0 Inspection . . . . $ Wis. Permit Seal(s) $ 3 C , 0 0 Other. . . . . . . $ TOTAL . . . $ o,o[} QI Construction O'HVAC o Electrical o Plumbing o Other SBD 5823 (R. 4/89) (. if ~ . WHITE -Issuing Jurisdiction ,V iOOO.O c;) CITY D COUNTY Municipality Number of Dwelling Location, if different 9/577 ::: ft;1~~~~ CERT. NO. C2 S So YELLOW - DILHR GREEN -Inspector PINK - Owner/ Agent L . --t~(,:/ NAME9c~~~' Md1ft- LOT ~ f . . SUBD I V, 1/--rC (!A~ STREET NO, /742- ;/U/V~S ~~IUJ or<., SIDEWALK EXISTING BUILDING GRADE ELEVATIONS STAKES SET AT SITE FEE:~ ( :;:: f) IJ DATE I Ill( Jq( ( ~.' . I!< ;iDDRESS BLOCK ~'l ARD ZONE YES LOT DIMENSIONS o NOIEl I /I! '5 , I 9 9 I BY K~ ~~/? DEPARTMENT OF PUSLiCWORKS City of Oshkosh 1/1/85 .. . .':l ., PARKLAND DEDICATION FEE COLLECTION RECORD Address /7'f2---~~4~ Owner's Name ~ ~ ~ t 1Vp<- /I~ Name of Subdivision .. . Lot # SI B1dg. Permit # 22--03 if No. of Units I Fee Required I Owner's signature /~6/9/ I i lIef /q-/ . f , Fee Paid Parks Subdivision Improvement . Accts, Rec.: 362-041