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DATE
ADDRESS
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
FEE' $2.0~
SUBDIV.
STREET NO.
SIDEWALK EXISTING
3025
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,r<').' /." ..'
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(ptO
BLOCK
YES
ZONE
LOT DIMENSIONS bO.2. 'f ~ 1!-9r q,q I ~~
D NO ~
B-!i~
BY'\L ~
, I 9e,S
~~~
DEPARTMENT OF PUBLIC WORKS
--
,~~~M_________~-~-"-"-
~
Permit:
PERMIT - t~PLlCATIONI\ND RE9omJ'
);)35 ~ ~
Ward I h
Plumbing 0
CITY OF OSHKOSH
N~ 1 3743
~
Address
:;;l~
Owner
Subdivision
Id. No,
Flood Plain (!)b 1-
Permit Date '6~.:2 3-37
JfWork
BING CONTRACTOR
;no Sewer _ Curb to Bu.
. Sewer Curb to Bu.
Main to Curb:
Main to Curb
Foundation
Size: ~"'feet ide X '-f~ feet long
Height: ~ Stories and Baserryent
Width of Lot
rcx;.,37 ,
Square feet area
(7 feet above Grade
Noo~(,-f~
.~ =::~~
8'.0.
Inspections -
Footing
Electric Service
Foundation
Sewer Fees
Service
Cub Floor Drain Urinal
Basin _ Garbage Disp. _ S. Sink
Closet _ Dish Washer _ Catch Basin
nk Laundry Mach. _ S. Pump
Heater _ Water Soft. B & S Waste -
er Bath _ Bubbler Conductors
ling Fr Tota Fees
~
cr,
Q-
--1c
'ING CONTRACTOR
Gas 0 Oil 0 Elec. 0
lioning Forced Air 0
m High Eft. 0
ley: "A" 0 "B" 0
lated Heat Loss
R.1.
Sewer
Water Service
Solar 0 Solid 0
H.W. 0 Elec. Base 0 Steam 0 Radiant 0
Supplementary 0 Air Condo 0 Ventilation 0
Direct Vent 0 Con. Burner 0 Flue Damper & E.1. 0
System BTU Rating
:TRIC CONTRACTOR
ic Service: New
'iption- Type
es
,nces
Temp.
Estimated Cost Fees Paid Date
TO THE BUILDING INSPECTOR: In accordance with Section 7-18 of the Municipal Code of the City of Oshkosh. it is agreed that if work shall I
discontinued ,for a period of 30 days at any time for any ca.use aft~r ex ~vat' work ,is comme~ced, a :so!id bar.r~er, wa~l, orwire f~nce not less th
five feet in height shall be erected aU around such excavatIOn. Such ame orWlre fence Will re In In pJsitlon untll removal IS approved byt
Building Inspector. X . '2/'.
In the performance of this work the undersigned agrees to abide b
codes, and rules governing the described construction.
3.-;2 s-83
Swilches
Voils
Recep's
Amps
Circ's
(Signed)
::d;y/iA ~~
(Authorized Slgn~
Address /1-67
Own
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;fJ~/~~/.--7- 1/57
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Phone
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Age
'ical Signs
Phone
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STATE OF WISCONSIN
OEPARTMENT OF INDUSTRY, LABOR AND
HUMAN RELATIONS
DIIIISION.OF SAFTY AND BUILDINGS
201 E. WASHINGTON AilE.
BOX_
MADISON, WI. 53707
WISCONSIN STATUES 101.83
PERMIT REQUESTED
~r's Name
~u-n A ~u E...
cr:ractor~N~kL
€S
PROJECT LOCATION
Building Address
1 2. '5 'J- WU~CCup...T
Zoning Dis~
1<' - l ~
WISCONSIN UNIFORM
BUILDING PERMIT!
APPUCA liON
DCONST DHVAC DELEC
Mailing Address , . _ . , 0
l 0 -z... u ~f:'t=E.e.sO^J ."S-r.
Mailing Address
\ l sq ~On;r~
PERMIT NO.
PARCEL NO,
13743
Lot Area
Yo
%,
D PLUMB
Telephone
Ls~-03Z'7
Telephone .
Z.'51- zoej .
A
~c.
T N, R
Lot No,
Zb
E(or)W
Block No,
.,..-,.
1. PROJECT
2. TYPE
Left Right
Sq.ft. Setbacks 8 ft, 7-// ~
ft. ft. ft,
3. ELECTRICAL 4. HV AC EQUIPMENT 5. ENERGY SOURCES
~orced Air Furnace Fuel Space Water
AMP adiantBaseboard or Panel Htg. Htg.
D Heat pump LP Gas D D
o Boiler Nat, Gas 0 0
DCentral Air Cond, Fuel Oil & ~
o Other Elec,
Wood 0
oncrete 8. PLUMBING Solar 0 0
o Masonry Sewer Coal 0 0
DTreated Wood Other
o Other ~unicipal
11. USE Septic
o Permit No. 12. WATER
DSeasonal
~Permanent
o Other
e applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Municipal Ordinances and with the conditions of this permit; understands
:hat the issuance of the permit creates no legal liability, expre,~r implied, on the Department or Municipality; and certifies that all the above information
IS accurate. :' 'Z;J
SIGNA TURE OF APPLICANT DATE 2;
D Basement J r; 3 <c, sq, ft, l-Story
"-t --l r2 /' 2,Story
J.Cl'Living Area -.::> .~\c) sq,ft, 0 Other
j3Qarage 4g<f sq,ft,
~ew 0 Addition
~Iteration
Gar e
Attached
o Detached
o Other
OMaster plan no.
(if applicable)
9. AREA
o Private
Municipal
CONDITIONS OF APPROVAL This pe~mit is is~ pu~suant to the following conditions, Failure to comply roilY resul
revocation of this permit or other penalty,
13. ISSUING JURISDICTION
OsH kG:; I-{
DVILLAGE
TY
DTOWN
OCOUNTY OSTATE
-:LQ-~~~
NAME
MUN Ie, NO,
FEES
WIS, UNIFORM PERMIT
SEAL NO,(S)
4'LfI.
J~4l9
l "$4 71
NAME
PLAN REVIE
INSPECTION
WIS. PERMIT SEAL(S)
OTHER( .I "5 C
TOTAL $
DATE
CERT NO.
DI LHR-SBD'5823
ISSUING JURISDICTION/AGENCY
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D~TE 2i:;j)PERMIT *. /SN3
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- GENERAL CONTRACTOR
. R~/6-
MASON. CONTRACTOR . ZONE
Width of lot 10"(3}/
ADDRESS 17-~ ~p &
uSEa/'f- .
Wo-xk con~ists of Ai::~>v 1:79~e:-L~
q,rr-A-CY-A'3~ {c~4A C. e- "
/72..T'Z"1~ .c ~Cf- 5P
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INSPECTIONS
REIvIARKS
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MAILING ADDRESS