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~/I- /,/, DATE I - iq - '64-
NAME/VI/l17ltU/6 f7 /:i;;l.LEVeeC;er ADDRESS 40W O..tio
LOT '0 I BLOCK HARD
S UBO I V. g rtt /lPP tJ j)/t.IJ.-r /bX/JIIItfd E ;2 - ~
, ----J. ~ 930 p - ~ 0 -..,L' I. -2/J
STREET NO. BOd. e 1__l!- 'M OW>i!..fL stoT D I MENS IONS /6- ,; / C ~
SIDEWALK EXISnrtJ~\'\Ji~ CT- YES 0 NO t;J':
l/~
BUILDING GRADE ELEVATIONS STAKES SET AT SITE ~~~ . ~~
2d
Is
, 19
't4
BY~
FEE: $2.00
b~L j::;~
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade est:,~::~d before excavation has ~. C ~~
}31/
/'~
ONE- & TWO-FAMILY DWELLING
PERMIT TO START CONSTRUCTION
Permit No.:
Date:,__,?_-IQ-~L
FEE
$27.00IN ADDITION TO PLAN E~~INATION/INSPECTION
~
STREET & NO.
4 -
STATE & ZIP
W't'
FEES
~~ (
CITY/TOWN
g UI<:::.D S'I+
D~..~ LING LOCATION
"'Z- H~OtLN' FtW,& 2-'1'30 f1cwiV-J 9-
C I Th. #f 7..6....WN~,
Ob~SH
~AAGENCY (BUILDER. ~CH. OR ENGR.)
l'l\A.m~.H b K. I(JU/LJ)((
&TY~s.1:+
'8-rAtJUl
COUNTY
W lNtJ~CSA-~O
STREET & NO.
, '1~ O/V\(2()
& ZIP #'7 fa.
C:::rt 10
~C'J
TELEPHONE
STATE
\
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, Ind 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 ~eviewed
and to relllove or replace all noncode complying parts of 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 %oning
permit and a domestic septic permit has been obtained from the local
authorities having jurisdiction in accordance with their laws and
ordinances.
NOTE: Complete building plans are
needed for issuance of this permit.
Footing and foundation plans submitted
prior ~o final plans will not be
accepted for issuance of this permit.
/<#;:::#~, /' ~dP=
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7 /
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DATE
OFFICIAL P n
fe ()vJ 6fI1) (Qq (v\. I({\...
ISSUED DATE
~-l 0.- '{;<(
NOT ISSUED BECAUSE:
TITLE Cl-I (ffF
FEJi. S RECEIVED
YI Q-7
---~-~----l
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I.N S' ' ,,(..(...(0 rt.-
DATE
~ -( o-f If
.~".'-;""U~l-~~.lit,;.1I ~~7~ -.4.1"1:. (~v-
UNIFORH BUILDING PERi.'1IT APPLICATION NO.: It; 3 8 '8
'ZOtl DIC PEPJU'i' Nu.: SEPTIC rEWHT NO......:
AUTHORITY HAVING JURISDICTION:
nu {COUv' (,
$00 - hf17? ('J c:; /0'"