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HomeMy WebLinkAbout0010490-Building ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 10490 TYPE: BLOG ~TG 0 ELEC 0 PLBG 0 SIGN 0 ZONING -J2-L FLOOD PLAIN~EIGH# If- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ., - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS 19 (;, S- #"'<:0-''''1>0'--/ ~ t< e PLAN NO~;> -(fS-=-'l(J~ OWNER /C~~.~ Ik(' Ife.J>(?r-~I"'r- ( -- DESIGNER USE/NATURE OF WORK /lj~2h{j s::r-1I- /~ / ~--f/ 0::.. f-, # Stories Class of Const. 8 ~ Height ~ ':31 , Occupancy Permit ~ €q :;::' t HEATING CONTRACTOR ~;~ ~~~ ~ Heat 0 NC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR (' '" .-. " T". Electric Servo New 0 c';:nge 0 Temp 0 Type _ Volts _ Amps_ F"ixtures Switches Receptacles Circuits 1''' PLUMBING CONTRACTOR K n ('l~ _BT _WH _Sh _Disp _OW _SP _ WSoft _OF _ CBasin _Lav _ San. Sewer _Sink Other _ Eject _SS _ Storm Sewer _ Water _WC _FOr _ L Tub _Ur ISSUED BY Date ~9D q.~ 19-e~ Park Dedication $ / 0 0 . Final/O.P. '7 - I () -8~ In the performance of erform all work pursuant to rules governing the described construction. ~ -/7-7 DATE 9d6'-OOO7 TELEPHONE # ( City Of Oshkosh 1/1/85 Owners Name PARKLAND DEDICATION FEE COLLECTt'ON RECOf<D .ICZePj-- ~<-c~~(3r-V.~ n ~ N.:t. 'ftr 0d: r< .' ke ((f"cLbr:> rcr . ~ " '~ ,. "- ~hrrfev~ "-.)~elMe./ / L.o-<I~ Bldg. Pennit # v! IV Address Lot # Name of Subdivision 'z/7--; ( /00 JoO No. of Units Fee Requi red Fee Paid cr ..~ cyZ:t . Owner's signature Parks Subdivision Improvement Acc:ts. Rec.: 362-041 -t:' ,': SUBDIV. STREET NO. SIDEWALK EXISTING BUILDING GRADE ELEVATIONS STAKES FEE: $10.00 . . ~p ~ _~__",~=-.:c:~ DATE 9- ~-8~ ~Of'6- ((Jv.-. (~o tf ZONE rr BY~~ ~~P; DEPARTMENT OF PUBLIC WORKS /? 1.:::;:": ~ /-. . I, the undersigned, owner or agent of the above descri~ed property agree to have the grade establ ished before excavation has comm ADDRESS BLOCK ~~ ARD LOT DIMENSIONS YES D NO~ SET AT SITE* 9 ,19 038}77 G- 39(,/ /;~7 1 l .. zetmJG/!Mm t1SE. CCr-'lI?LJ:l..Ntt CiEC-<LIST I. fy-t ~11 GENE:AAL Bui.ldi.ng' Petmit J .,.,.,...-i..... 1> ; COnfo' Non<atfo' ' -....."=':..c:L- z:nu..nc;r_ mJ.n9'_ .:;:-,1, f ."-' t::J I eKo h ~ it w~ DiInension IN'- f' wi: JU:ea 0.~l =-r:X~ ~~3r=e ~:/ 411- ~ r- ~:?~.d;;, ~ ~~' .~~I'P- __ )~~ *~~~Ot'~ ~ NE.W~ ADDITIal i\~ l I t _ Accessozy Bui.ldi.ng' Pool Fence _ OeckIPatio Eloat:house _ Sign _ TJt:i..lity St:ructm'e Porch _ ot:her (specify) m. ~~ Job I.oca:l:ion !CG-,/ :I At..'tl.mA1'J:CN ~$i.hqJ.e' Family, _ 'l\lQ-Family _ z.l1lti.-Family O::ama!:cial _M:mufac:turing O:xtclies Deficient (./"'"' - t../ Use lot Width , lot Area F1QQdplain . F%:Qnt Yard Rear Yard Side Yard (R) Side Yard (L) P~ :BIxildinq Area lot Area per Family COmer Iot Other (specify) -~' e,....- V'" V - ............ ' V- - ~ V- ......... ......... ......... ......... ~ ...... ~ :~/t: . Defieiencv/CcIme1t.s ~~IJV~~. / '// IV. REVm-l AtmiORIT! The Pl.ann:i.n; Director, or appropriate designee, nwt approve all p.la.ns, exeept the followinq: (ll Alterations or interior....-ork when the use is oonforming and when no change of use is pl:OpOsed. (2) Maint~oa items, e...g~..,. sii'il.r!q., wi..ndaNS.- etc., when the use is c:onfoz:minq and. when no cha.nq.e of 'USe is pl:CpOS.ed:.. Instances whe..""e work o::xrplles with the a1:xJve crited.P., tl"..e petm1.t can, bia revie'h'eC1 by the BuilO.inq Inspector without refen'al to the Planning Di.rector. ~ APPROVn> NO!' APPRJ'JEO Plan CormlissionAc-...ion Required Variance (s) Required ~.m~~~Jl~~ =, rj;?18~ " '.\ .-' ; :<.; ....0....." STATE 01" WISCONSIN .. Depurtment or Industry, Labor and HUman Rel~tions Sufety and Bl'.11dingf> Division, Madison, WiscOl1s:l.n 53r{07 ...... !.... ... \/~~~,~,,~:~:'1~:.~ 4,;.,..-, '}I\'/'--"~ 1:;"'rl':~~;'~~ 0" "~' JR,";;' B'.., S'H'i!:"i"'Ei~~,."~~i~~i.fi ~;t~ ;;,~\.)!~ ~:~;1 b'-';,; i' ~.j. : ,', "".', ~ ' J:~ ~~Ji -:J "",,' W~ '.'" bMW,,-, ViiJ ' - '. :-'" ." ' 'AI JOil NAME: ~t~~~~~ DESIGNER: .... ~)FF~ . LOCA'l'ION: I ZONE::S' ',DA,'l'E. ~/~<2>,' ". -",-,.. ..~.' I NS'l'HUCTIONS : 'l'hiG worltsheet is recomme,nded fQ:r determin:Lng conf'oiiri;" unea with the Uni:t"orlll Dwelling Code's Energy Conservation Standards. Dwellings may be evaluated by the System Design Method or the ACi:ept~ able Practice Method. Heat loss thru buuement walla and f16oro where i.nsulation is not required by code may bel included in furnace :dzing culculations.- at the option of the designer. Syst~m .Def1ie;n heat losses not exceedi,ng the louses determined thru ,the code d requirements by'. ' more than..l ?~ are considered accept!3-ble. . . .. . .' ..~_:" are~:Jcalcul atl0~'1S '. " '..;",1 GHOSS WALL AREA: li'O UN DA'f ION WALL ABOVE GRADE:. '.' ..' . h"; ......~. 4fz- 11/<0 _ . .,.,-", . .... ...~:. . ......~ ....' r',;'II,.:. , ..; Ii .:"::''-'........... ..;:. ......'. .': ':'~;.~;~~.- " '-"-'" .--', -_."'.; ....'.~~I. '. .."", ..,,,..;.... 31068 sq. ft. WINDOW ,)\llliA:Oglatis t;hc 0 unit she ., ~ sq.,ft. 11'OUNDNfrON WALL D.ElpW.,'9lU\DE:, .;~:::, ~ sq. ft. 25b' ...:.;q.' 1't.. li'LOons OVEH ;UNHEATED AlmAS: . . ':.,!,'~" '.", '" .'.,- '''''-.., ... Do'dR AREA; ~.: ' ,,~.:;.., ",..', .....' I.. . "'~" .,:' ',-':'..:,... ;, .5~ sq. ft. CEILING AHEA: NET (OPAQUE)WALL AREA; OTHER: ';\ ~q." ft.." OTUEll; (4 t ; , '. d.7tfj sq. ft. 3Ob/SQ. ft. "'(1, f'r ~ '.. J*...;,~. ~ III 6q. ft. ' - . 1'.;,'\1l Nl), snD-S51U .' .// '"t, """'(.. '. ~.~ It.:6.,,,.,? ~~ S''"'.''''''iY'' - 1 r",- . ~y. ,,"~.' . ..... i ,.: ~~i l~:c. ..,' '-....,., >:J w~ ~i/..j;J ~ ~ ~ IN:)I;']WI'~'i'ION::;: CLLlc I, I ,I.L' n alld U vulw:.:;; u~3ing l],'ABLE A-lj. in ],;. ling, eOell' Uo,'d'.. ~)('p(i.rat,-. ".tlculations fol' ~e:ystems having the .san;-,) .li...ul- a ttl:)!l tlU t (i:1.1':1'(;1',;I,! :lll L'l'ior or extel':Lorf':Lnishe8 j,s not .lJ( ': ,,;: .';;l.ry P.l'l)~-j Cit,:d i.llC: ':;Y;;I.L'JII ,; i 1.11 Uk lowe:~t H v::.luc is used in the ,.;;/:: [.u;) 1)(.':3]1'/1 nl' Accq) (;\.'C! I 1':,cLJce calculation. ". L} k) "'," ''':i'''~' '::il tl \ ,;',' ,""! ",. ~ ~_'l :'1 ~W ~.... L;yrp (; 1 1ii.'~"~.'.'D'" I r.' ". d . U' ""I:" '" ~ I,., type 1 'f~:;~; sol r~iJ.V ~ 'Ul.lt 2 j Ii '.'XLI,,'i'.) 'Ji' j--~... .- - C ~.L V cay :;01 r i IIii 1'7 " /:~~, . "I I'll L~.....~. ..... ~. I II \ i L..t=1 rl-_~~ ""..", ~""17 - ~~. ","/ 1"1 <.:::"\ c. '-' L ,j,. U 1. .l. ..L..wa. . ..L {y . __ , '. ~~;-A '::, -fini~'h' -- I'''::::-'I==~t ~ i ''''Lllo.tion 50 _ I ~j . , l~~c~~~~i 'nL~ xxxx ~' !'~'X; A ' -~- . .LnG u la tion ~. ,. .~'..,..';._._~ -.=;a'. .1 :Lnt. finish J-___ interjor film .61 .61B .01 .61 ,. '/'(yr/\ T, R 5l ~ j. ~.. I . , :'(i'!';\ -j II IJ II l/H 8 ~" Uft..J ,0/1 'I, i ~. , ..... \ i"""';.l ~>'" "\...""'I..t.. f v' ;.1 l'~ 'c. \iN ~ U ~~ J;;=' Ii" .'. , ...... I. i j " \-J.~ Ll "I :; .~......... '"\ - .' " " . ", ,'- I ~ \. ~ t. ,: , " \ . l 'v ',l I I . 'i -)'1)\ j, 1\ lIu" l/n ~ ( .. "l? 1\ . J' ( i __e_,_ ~-- ~ 1-- ~ ; ~ ~ I ~ ------... , 1+,,""': 68 , .~,";W Ilir-. ~~ -..;-~-;.\'_..:...;" (' a. v s 0 .1 ~ < . d. i ) 1 -'L~' ~~~.!_~~~ 0 l' . fi 1m ! I .. c xt .:...fini s h '-I---I,=---, J-----.-.... _. -f ,-.L~!0.~ 1,~ t i OJ=-_ 1---'-- I -.---.-.----2-~--L --,---j-j :Lnt. l'inish. -..... -- -"!-~ --D~;:-;~~-'Y' film ~ -1. I . ,,~ . '~'-'''' . ."". lJ .. ""'. ~,: '\: ',liGJlilt. 'r"""r &:'Ja !;~) 1ib'" U~~J!,~l6 - L X.tL'J'l,:.c j'j LII, .J '/ ('xt. (inJ;:.,;ll -". '-~~~'--__"'_h__'-~~__. _~ ~Y'_.,_. rLa~3 OII"V e b 7 ._--~.._._._---'.-_. .....----.. VJOOe! jnt. :l':Lni:.>lJ _. --- ~"'-'~--"._- :iIJLI.i'jIJi' I', 1111 .~ . Ilu::;uLILitlJ! ..-.lI!...... '~,... A--fl '1'0'1'/\ [, H "uti I/n ~; j.::il .^ 1;:;t thru ) I'd root L~th foot 1> (: 1 C II i~radc if) --: .. ~~ ,,. ...... ~ ~ .. " ;J. ,.. . . i . . ,~ \. .) t~ tJ-. ~.... u w ~w~ 0 v be 10vI ".r;!(le to baseml 'Ji I !' ! . ,., "i4J . ..... ,."",,, I (,Jl ) L' r l(") tn~;u1~1. I i \ " I ~~? ? ) ~ :', . 09Jj. ~-~ walls H 5 ri,'~iu I , :J. .1'cl 113 06j ~ J" . . H 11 l' j b L~ 1'! ,1 . t:; ~> . o 'I ~~: . aLl i~ I 11// ') x lr J'c Ulli ni~: ,,- 02'=-,__j fIon},;1 110 1. n;; u 1 it : ! or),. . '-: ~) . )\ j;,!. oli, 1 d (-'~':'~ : l 'j i' "t -, . ~; i'l II :' I! 1:11- i (>1"1 t', . 1 ~~~ jY ~~ \f \ ,,~"', - \~. t [",".r' ~"'P""', Iln":'.',.'.11 'I'i"t:;~t;-l'o."~..,~,;'-;jf ~.;jj) \..1 ~.' J . i\,.l ~ ,II:"';'^ ~ ' ~...............- 'WI a ' H ,...... . .. p e r:':'li6uri ..,-,. '~', "~-:,::'. -.~.~~~x ~5i~(~.~O+ :1 'j", I Le~'~3t'~iL~~;~~i~~~')-'~ - (PO e______~. ...__........__,. .~", ' type!" ,.' V" (=, __x=__...lv.J.I"'_"'_'__ . ::> ~~ 1_. ( ...:..~..;~: ):-.,~~. /'L -~i~J"{:i~~t~;~n~J ~ 7~ '\ ( ,. "I ) t,yp' ~..'. '. v_~..;~:':::'_~-::",_':::.:.=-::':::.::::.::=;:.;::.;'.~:.~ _____ '; '. i., (...__..__--.:x:.___>: ) 1 -r '" 1;................... ~'~ 'f I' n,....~ tt/I~.-':!.' .,..:ji~:~~~~D=t~~;.t~~ ~ M' .' f !t.f~ ~'., _ .~ .r~---' -- ft'lr1r ~ t, ) lidO';)::': I,... .____'_________.... t. ~? ~ i' "/' i ,') CIOi.il'S -.-.. .-- '. ~ '.'--'-'~' .-.._----~ .", ~ ) r ,._L__.! ~--4d-l1.su i G ' d . , .-. f; I <<. ._~:., ,'e ~ t") % 0..- ~~ \~! ""<.....J \.......' ..y:; i::"::':"::;.:"\':q'> "." (;t! i1 '~ :i oJ:: t~> ] LI',( .._.::-.. ...c:...._._... 10"l . 1,1 . r/rl I/o ';i~l[~.~:~p, -~ :~~fl.:t,&11~0l!l . . ;~~itC~\.:'.." '..~ ..... ....;" ,; ;' . .......:\/~ CONS'I1RUC'EION BEAll' LO~)~ 1. "'':',:;"'', . :2lB~ I 'Be ....;...... . I sB 11' .ij ~ ~ A '.~...l<Jfr~. , ~ . ,'.........----;---..___e._,__.*-:--_ ~ I.' ,1"1'; COMPAFUSON ~:~~ - H~ _..~ - ~ ~ . ")HIJO\'fJ':ln d t"-'''~l << i..,cLI:; al)I.)V0 'fdtn' ;i . '" . . :--.. .-.-.. .... --......... ~",.d.L;; U\)l)VC L~l'ude. ' i....., -...-- --.- --.------., ;.;": L.rl..<::~!?Y>l.._.(?!:.~_~.,::_...... dS-~ If :', il'n ;':l.bi)V':: p:l'cl.dl'~ _,' , ;' . .........-. ._..~............. ...1.......-------- _ . . ........ ..........~ I: : it; b"-~O,:< 1]:":,,';0 Jj I, 1.7 Sb_ __,: ':0_ 50" ,. -1.:r~f;':1 ~"'\' ..1 / c e:Ll,Lnc; 10'/)79<A .029&> B.:;'7.i ,i'~...'.'''..'.'.. r ,~ .. .......... .,..~.., ~.... ... .... ~ p...,._._-~~.t.. ----.----:.J~_ _ I L i ' ':.....' ;;Jr;::'f":: ftt;~W~~ ,~~i~~:';::i ....;. . .."~:-~;.~~::<'::i lIUll -l(.)i- TD:.. n'l'illlLOS.S"'~ ...... ~...-:....'....~ 1 _'. ~. .,}~ r 1ilISIl.i. .33~"" .....~_: '" ",,:".::~:+-i ~* ~~'''''~ --:-~",', ".-t"'i o t ""_~~~1~".1 J LOSS I 0~{b' e , ~~ -; .~,,,.,.~~'If:t._... -~ '~r -I J\ r: E:!\ & +~ 3~ _.AZ- " 1-~ I.'; <. :\,i]H~U'l' '1..ullll'.......'.ti {l tGtE:A .' ~.~.~~~ feet ~. 7/b 11- -- ~ ~: -11, 17 - "'\'P.~ ;'.~~"::; . ; "IJu'11;; i:i':,l'(~ tfuln 3 bcJ.\,,';: , j':.uk '1'1 I'd:'!';: inside temp.. 11: i: ilL; tahle em parr,e :', 20 di.:'gl'(;eS .:J ;v*" "lti.;:t. A\;';~ it.' "\. '. .~ lf~ ..,.,~.,....,,'..ri-.~.i:~~.,~:.,\,.,. . "'" ........' t....~.~;! -,;.~,.', .,~'.,\',".';~.~~ ..'. \; L. t,~ \\iiiZJ,\,,~,;,!';3 ~;' "~v iii" .if ~,,',) t,~~'J' '. ~~',!: Ji. ~:.~~~ 'ol.-.'~~~~ ~ ~ ~ I INSTRUCTIONS: for eompletion of acceptable practiae method, please re.fer to Uniform Dwelling Cc:de, Chapter InJ 22, Energy Conservation Standards, Appendix Tables 1\-1,2,& 2. I,i.: 1,8 AeS'JE F()~J:iJ)H'l'ION \H\.LL \-llNDO\.J Cl.I\ZINC;nSin~lc: w/storm rJ.1nsulated glass Drriple pane DOORS :Dnsulated SIDING Q\vood (It .77) B~~;~~:"lO.O~, .. . L[alum(IU. 82) UU~U~UL W/~LU~W I'. WINDOW AND DOOR AREA PEPJ1ITTED % INSULATIOH TYPE: GJWSS viALL ,\I~EA(from \vorksheet. page 1) = GLASS/DOOR AREA(frolll worksheet. page 1) = PERCENT HTNDOI.J/DOOl{ AREA glass/door area PERCE~T WINDOW/nOOR AREA = glass/door area .___sfluare .t:ecL. square feet. + gross \'1811 area % CEILING TNSTJLATION TYPE: R VALUE (per inch) i L- I ,. j UUNlJ1\TIO;~ t,ALL 1)'PQT'Il'FD THIC1(rmSS (ppr t.:lLl.:, A-3); j . "-,. LJ \..J I " ir:l ~ilvrt:y~_'lo vel' framing .< """:.,~,,- '. "" ""~'''''''''': (\~al1s must be insulated La be in con- formance.) WINDO\..J GLAZWC: Osingle OSingle w/ storm Oinsu1ated (double) INSULATION TYPE: ______.___________. R VALUE ______ I~XPOSED FOUNDATION AREA(from worksheet. page 1)= .'. .' square feet. TOTAL FOUNDATIOn AREA(includes above & belmV' grad~)::;:.,......~--square feet. PERCEI~T EXPOSED = Exposed foundation -:- total fdtn = square feet. PERCENT \HNDOT\f AREA PERMITTED(see Table A-2) , = _~___percent(~~) PERCENT IHNDOH AllEA(\dndow area 7- exposed area) := . _J)ercent (;~) L:,..."",..," \<-1 i\;': 'fi;fM ~(f, 4:~ J: Ji~ VOLU}1E CALCULATIONS: L~VEL VOLUME CON. TD A/C'" B TillI HEAT LOSS ..' ~7~9 Basement . j.i..~~ .018 55 ,'Z-s- ;-e_......_e___ .. Level 1 bLl 336. .018 e:5' I) 10 '3 ~2-.. ~._. ....__.._-._..-._-~-- - .- Level 2 _7~ .018 ~ ( ~ s7~ t---.-......-.m.----- .. I Level 3 .013 "'AIR CIlANGES. Recommended changes be t\ileen .25 and 1. 00 INFILTRATION cJ-7' 5"/1 construction, number of openings, HEAT LOSS depending on type weatherstripping, caulkinB ~tc. '1~~. ,r; SIZE ALLO~~~~~!~.._l~~:~_~~?~~. ~~.~~)In...~~':~'C_.?!.. __ -5~ (p o-D INFILTRATION LOSS (from above) A 6"1'7 _ ____ __ __,,_._______..e_.e_..___.__ _..___.____.___.._-,__.__ I)ASE;11~Nl;-HliAT' LOSS (from page 3) ... (c; cf/b__ -.- "--'rc;.rAL--i)\vEj,i~it~G--~lit\i-'-Loss;--"'-'-- --1 ~ 5~ S- TOTAL DUELLING LOSS q;., 53S- x 1. 15. HAXH1UM FTJRNACE SIZE "']CX::'{/S-.* FURNACE SPECIFIED ,\ * Furnace output . -'3' q. 'fl. ~;'}[: ,,(rrll WISCONSIN UNIFORM BUILDING PERMIT APPLICATION See Instructions on back of ink co ":.. I:: %TRUCTURE Mailing Address . . Stare of Wisconsin Department of Industry, Labor & Human Relations Division of Safety & Buildings Box 7969 Madison, WI 53707 Wisconsin Statutes 101.63,101.73 ..................................................... ....................................... . ................... . .................... ............ ... ...... ......... ...... .. ... .... .................... ................. n. ............... ftE...,ft~M...:..:I..~~'.R..:E...."U:..EsmED.....:.' .....~: n. . ::1:;-;. .;: v. ::::~::::-..:-::::t\t:~:~:~~ .-: r; ~'- Setbacks rrF.;ete.CtB~..t: E~tranc~a~1 Size: ~ amp Service: ~nderground D Overhead ..;gQ"~;:~(t;f;Qp.."gIT'g" Basements 2~q Living Area 3'?5-& '7 Garage /(Xo1 Sq. ft. Concrete D Masonry o Treated Wood :,:.,,:, 0 Other aFOS!?' o Seasonal ermanent o Other %, SECTION ~ete-'t~ Front 6 S- ft. 9o-r- ft. {.tiRVjC,;<mjPMENt: Rear Forced Air Furnace o Radiant Baseboard or Panel o Heat Pump o Boiler ~entral Air Conditioning o Other 1:(UPUjMa.INGF:~" . ....................................... . -=rz ~ II fr; - crS2!e.- APPLICATION NO. PARCEL NO. D PLUMBING ,T Lot No. N, R E or W Block No. Z Left o 0 ODD ODD D D Right I ft. I Z- ~j~;:eNeB~Y$()U$Cer. L.P. Oil Elec. lid olar ft. Fuel * Space Htg. Water Htg. * 0 Dwelling unit will have 3 kilowatt or more installed electric space heating equip. Infiltration control option is: 0 Full sealing of joints. D Blower door test. 0 Exterior air infiltration barrier. 1~;~HEA"t.t()$$Gf.l)p~i~t~d.} Envelope ~ '3 ~ BTU/HR Infiltration Z. 't~ 1"40 BTU/HR j4;:g$.;]'NAT~QqQ~J: . 2'~ 00 $ I The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Municipal Ordinances and with the conditions of this permit; understands that the issuance of the permit creates no lega' , express or implied, on the Department or Municipality; and certifies that all the above information is ;:~~~TUREOFAPPLlCA ~ DATE/-/7r-~ CONDITIONS OF APPROVAL This permit is issued pu nt to the following conditions. Failure to comply may result in suspension or revocation of this permit or other penalty. j!~I;I~I~i.::.:.:: t~aURIS:DlOmION:~~ .... ITY 0 COUNTY Municipality Number of Inspection Authority Lt.2-rz..~~ WIStUNIFORMPERMIT .:.':":,..tN.dF:~::' o VILLAGE D INDEPENDENT Plan Review , . ,$ Inspection , , . ,$ Wis. Permit Seal(s) $ Other . . . . , ,$ TOTAL . . . $ SBD 5823 (R. 04/87) onstruction D HVAC D Electrical D Plumbing D Other 30 (Q -Zo WHITE -Issuing Jurisdiction /'80 OO~ Municipality Number of Dwelling Location, if different NAME DATE tt-r?--~ 4~40 CERT. NO. YELLOW ~ DILHR GREEN - Inspector PINK -Owner/Agent h~/o-~6' . ~ CJ k __ /V=--<--<2~~_~ \j ~~~ r::r . ~ '-L, :Y "/, /'7 ~ - \..,. d.'e~..~ a, __ , '-u.-(/ N~ ~ ~ ~~,/ ""- ' /,j'C:..y~ ~c:7fz..~ Z-t3-??? T<:c OK I'Ib -:\ A" < .. ~~,~7;::i~~~ 1 lA.- "S . ______.. ~" _~; ~ tt " ',~ ""~~ " .~ i J 'G-c.~-~ -d: ~ Of<. ~ . *;:!z.'f/or ~_~~ 0<&..{J- fi/ J? f(i> j?~ 01<: 44\ ~.-