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CITY OF OSHKOSH N2
PERMIT - APPLICATION AND RECORD
28053
TYPE:
BLDG D HTG D ELEC D PLBG D SIGN ~ONING
FLOOD PLAIN
HEIGHT
ADDRESS . ~O..s:- ::.-t ~ .r_f",.1 =c-...
PLAN NO.
OWNER
NQrc..o .:s.
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DESIGNER "'
USE/NATURE OF WORK 1c=~/ 1iE~€c-f-
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A-J,r.,,~r.&~.( '''-:\
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Y-hP"-v
4~?' ~c-~!'~
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7,~~9L
BUILDING CONTRACTOR ~V_-' ~er-
Size Sq. Ft.
Foundation ~ r--I-~ [ k
# Rooms
# Stories
Class of Const. %?::>
Height
Occupancy Permit
XI~
HEATING CONTRACTOR -- .-
Heat D AlC D Vent D Fuel/System
-----
)
/
Heat Loss
BTU'S
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,.--"'...----~.
ELECTRIC CONTRACTOR ~
C--
Electric Servo New D Change emp u-------rype _ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
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C
_Sink
Other
_FDr
_ L Tub
_DW
_SP
=-wsclt-..-....... _ CBasin
_DF _San. Sewer
_Lav
_WH
_Sh
_Disp
_BT
_WC
_ Ur _ Storm Sewer
_ Eject
_ SS _ Water
ISSUED BY
L
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
ADDRESS
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Revisej: 8/89
ZONING/LAND USE COMPLIANCE CHECKLIST
CONSTRUCTION DATA: NEW CONSTRUcnKN
JOB LOCATION: Z---ho s...--:;:r-- ~.ra M...
~ROPERTY OWNER/CONTRACTOR: nru--kh. 1ft-r~
ZONING:
ADDITION
-.. ..,
ALTERATION
PARKING LOT
-
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
>~~ Ie .S':''.3 ~ r . -Y- P' ~ ? L ~t-(/ 7' - 8 - 1'?-
COMPLIANCE CHECKLIST (Check on~y those applicable)
DEFICIENT DEFICIENCY/COMMENTS
Use
Lot Width
Lot Area
FloOdplain
Front Yard
Side Street (fra1t yard)
Rear Yard
Side Yard (R)
Side Yard (L)
Parking Spaces
Building Area
Lot Area Per Family
Corner Lot
Landscaping
\ Transitional Yard
I
\ Off-Street Loading
\
~ Vision Clearance
Height
REVIEW AUTHORITI:
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) t~aintenance items,. e.g. sid,ing, 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.
~PPROVE; DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: