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SUBDI V. )yr ~o.d,/Jy
STREET NO. /;25:5 /I~ (]f-
SIDEWALK EXISTING
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
FEE: $2.00
"";-~
DATE
ADDRESS
BLOCK
-,
~
tf!'l~~~-:r20'-
WARD
/5'
ZONE a(..- f~
/ '. I
LOT DIMENSIONS ~6./C. X //j,:J X 87~9 X
O ----e::r /clS, ~9' f .
NO XT
7-/7 198d
,
YES
BY K.,J
~e~~
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade establ ished before excavation has commenced.
~7
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...--.-......
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ONE- & TWO-FAMILY DWELLING Permit No. :
PERMIT TO START CONSTRUCTION Date:
--- ----------
FEE $25.00 IN ADDITION TO PLAN EXAMINATION/INSPECTION FEES
JjWNER j~~ reeD STREET & NO. I /19/ t -c; I y01-: /7 ~"J.:-. ;;J-O c;L.
... VUC:>LP;:. j '" ~:::. ~ ,",' " ' /--...
/iTY (TOWN c0~E & ZIP 0~gDZ-- TELEPHONE
D5~/Cb:S I~ )
i /. DWELLI~ LOCATION C~)ur~~ STREET & NO.
255- UrL/);U
BY/TOWN COrB:Y f3
(5 fd- J<-v-S H ttJ..ub ~~
AGENCY ~~ILDER, ARCH. OR ENGR.) S4ET & NO. ~~ ~f\-lL ST.
P'0 "- ~/ Ii tC~S Coj-J~(L0cT( Drf-J o 6 v.....:> .
CITY S,\AB;-::t ZIP $ <q.. q () c..~ TE~PHONE g -- D8'
n~; H- ~/Id- ::L3S-~ 7 U .
I, the undersigned, request to begin footing and foundation work prior
to the approval of the plans and issuance of the UNIFORM BUILDING PERMIT
per Ind 20.09(5)(b)2.
I have reviewed the specific code requirements of the Wisconsin Uniform
Dwelling Code, Chapters Ind 20, Ind 21, Ind 22, Ind 23. lnd 24 and
Ind 25, as applicable and have shown compliance on the drawings.
I agree to make any changes required after the plans have been reviewed
and to remove or replace all noncode complying parts oJ the footing .
and/or foundations.
I agree to proceed with the footing and foundations only and will not
continue with the remainder of the dwelling until approval and a
BUILDING PERMIT has been issued.
I also understand that prior to the start of any construction, a zoning
permit and a domestic septic permit has been obtained from the local
authorities having jurisdiction in accordance with their laws and
ordinances. I
NOTE: Complete building plans are ~ /I(~ ~Y1~
needed for issuance of this permit. O,iNER/AGENT SIGNATUR
Footing and foundation plans submitted '7-- ;)-5--- go
prior to final plans will not be
accepted for issuance of this permit. DATE
UNIFORM BUILDING PERMIT APPLICATION NO.:
ZONING PERMIT NO.: SEPTIC PERMIT NO.:
AUTHORITY HAVING JURISDICTION:
OFFICIAL TITLE
ISSUED DATE FEES RECEIVED JDATE
NOT ISSUED BECAUSE:
-6072 (N 5/80)
'\~>'::/
( OWNgR~ p:S j-IP<:.H t='i5LD
DATE ~-~~-\'iD PERtlIT II -bCA~
~ e L2LJ (~,
GENERAL CONTRACTO R
g-\i~
zbNE
ADDRESS I~- /-JULUdU C}:)ul--T
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