HomeMy WebLinkAbout0001536-Building
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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N~
01536
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ADDRESS.--:::2c9/b f!tc.t<ojZ;y LA-
OWNER &t!:::e(l:t ~(-Je;q,J /) etLG/Z.{ tU 0
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PLAN NO, (]4 -5""53 -pcf(,~
::<;:J..::J-9 1-1-1 c/C-oll- <( LA
DESIGNER
USE/NATURE OF WORK ~ SI,.,)~L.€FAM /( y I2E-s t~/ Arr,ae.I-ltrL\ CAt'Z./4(;e=
lor S/~f 1~()C4P- ~. 70 L..1~ ~ 2Z-~
BUILDING CONTRACTOR 4)( e///E?; &p5//lUc..r/~
, ,
Size Sq, Ft I f.J-S- # Rooms7f.3;14rH5# Stories ~
Height ..:2 4-1
Foundation
Class of Const,
Occupancy Permit
HEATING CC'NTRACTOR
GJULJ#,J
&:7&:s- /P&t-
Heat Loss'
BTU'S
Heat D NC D Vent D Fuel/System
ELECTRIC CONTRACTOR
{,J
VPl# I P".$
Electric Serv, New D Change D Temp D
Type_ Volts_ Amps 26-0 &6
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR cJ 1/"15
_BT
_WH
_Sh
_Disp
_ WSoft
_DF
_ CBasin
_Sink
Other
_FDr
_ L Tub
_DW
_SP
_ San, Sewer
~Lav
_WC
_Ur
_ Storm Sewer
_ Eject
_SS
_ Water
FEES: Valuation $ ~c;::;;.
ISSUED B0 ~ ~
I
.{
Permit Fee Paid $ I i^o
Date /0 - J>..-~
Park Dedication $ /0 0
Final/O.P. 3,/';/1 /~ 7
In the performance of this work I agree to perform all work pursuant to rules goverl'Jing the described construction.
SIGNATURE
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( ..6ATE
ADDRESS
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;;2.36- gOD r
TELEPHONE #
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,~ ..~ . .' . 1. '. , DATE ..~. ~71 <(ClJ>~
NA:O?~d- f ~~6 ADDRESS;{,Q ~ ~ ~ry, ~A "
LOi" ". . d--80. .' .... '. .' . . BLOCK ,--,-"' HARD )C-
SUB91 V qri-~. .)t1./t.(P4{J?d- ZONE _~
. . ' . i . ..... . .' . /. (
'STREET NO.dOISM(!Jq)f2-Y 4- LOT DIMENSION? Clo >r I~ 7 /.I~
YES 0 NO~
SIDEWALK EXISTING
BUILDING GRADE ELEVATIONS 'STAKES SET AT SITE
/0- c;;,
19~
,
8yA::fJ
FEE:
$lo,OLf~
. . (L
~.h/
DEPARTMENT OF PUBLI C WOR~ .t5,
I, the undersigned, owner or agent of the above described property agree to have the
grade establ ished betore excavation has commenced.
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- "c., /.1 Ij': ~ 1::'. .3' dJ).
<--../ .. ;' 0...;__ll-.7 ;I,J
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~.-P~7
ZCNnIG/LAND, USECO!<PLIJ.NCl::: CHECKLIST /
~ ' _ . :_';:~, tg-~7:~, /l(pr J1v;
Buil.di.nq Pecoit r ZO~W Confotl1lin;_ NoIK:onfotl1lin;_
Job I.oc:ationc201,C;-- #-C/Ct:P/ZI/ L.A- , '~ Dinension ," , -:'-
Property'Owner /!; fJ J/Jff~,4./~ Lot: Area .
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<e' ~
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II. . c.tNS'mOC'I'ICN DATA
Oescri.be ~: ~ ~L-
;;2' .' 5 '\-/zJ!/~r
j.ff/ /177'~ij--
V m.w~
I
_.AccessoJ:Y ~
Fence
Boathouse
_ Utility St::ruc1:ure
_ Ot:ber (specify)
III. ~ c::m:x::I<S
Catclies Deficient
~
-
V
~
~-
~
@
V
-
~~-
v
ADDITICN;'
. At:mP.ATI~
,'X$ih<1le' Family,
, 'l\lo-Fami1
- "r,
MiIti.~Famil
- . ~
~
-.0"._ .
MmUfact='
--- ,~
Pool"
_ Deck/Patio
~Sign
Porch, '
Deficiencv/Carments
Use
tot Width
tot Area
Floodplain .
Front Ya:rd
Rear Ya:rd
Side Yard (R)
Side Yard' (L)
PaJ:iti.ng
Building Area
L:rt: Area per Family
Comer Iot
Other (specify)
-$./~ ~i-Mh~
c(;dJAV :'f~ r€f'3
IV. REVIEti At1mORI'lY
,-
The Planning Director I or appropriate designee I rmISt approve all plans, except
the followi.nq: (1) Alterations or interior ....ork \When the use is a:mfonni."1.q arxi
when no change of use is px:oposed. (2) Maintenan"Ce items, e:,.q.;,i"~ wi.ndcws:t:'
etc., when the use is confoDtting an:i whenrx:> change o.f,~e is. pmpos,ech..
Instances where ~rk o:nplies with the ab:>ve criteEia,' tfie.. ~ .~, 'k revie.-.'ed
by the Building :rnspec-...or without refe:r:ral to t:he Planning Dire<:tb%:":"
V APprovm 'NOT 'Al?PRJVED
Plan COntnission Action ReqUired
variance (5) Required
~9(~0f~~
R1\n:
~;9G
City of Osh~osh 1/1/85
.,
"
Address
Q\tIner's Name
Name of Subdivision
Lot I
~
Bldg. Pennit ,
/s~c;.
No. of Units /
Fee Required ~~
Fee Paid I ~
e
Owner1s signcture
)~ ,-!?-- ?-6
Date /d.-,9' .,-7~
, ". 0_' -. ..
Parks Subdivision
Improvement
Accts. Rec.: 3~2-04:1
State of Wisconsin
Department of I':ldustry,
labor & Human Relations
Division of Safety & Buildings
Box 7969
Madison, WI 53707
Wisconsin Statutes 101.63, 101.73
WISCONSIN UNIFORM C4-
BUILDING PERMIT
APPLlCA TION ~ -. eft;L
(See Instruction on back)
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APPLICATION NO.
PARCEL NO.
~VAC ~LEC DPLUMBING
/ ~ " Telephone
MPt:F
Telephone
,T
Lot No.
-?&
~?;;?O
Left 1./
"7 'Z..
ft.
N, R, E(or)W
Block No.
Basements
Garage
4fp;;J-
Sq. ft.
The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and'other Muncipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no legal liability, express or implied, on the De artment or Municipality; and certifies that all the above information is
accurate.
SIGNA TURE OF APPLICANT r;.
CONDITIONS OF APPROVAL
~
This permit is issued pursuant to the following conditions.
tion of this permit or other penalty.
(2G/'G/'P;;'
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DCOUNTY Municipality Number
Municipality Number of Dwelling
Location, if different
Inspection. . .
Wis. Permit Seal(s)
Other. , . , . . . . . . . $
TOTAL. . , . . . . $
DI LHR-SBD 5823 (R, 11/84)
.'!fo
DConstruction
DHVAC
D Electrical
DPlumbing
DOther
DATE
Plan Review. .
43, r 44-
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CERT. NO,
WH ITE - Issuing Jurisdiction
YELLOW - DllHR
GREEN - Inspector
PINK - Owner/Ager''''
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