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Home My WebLink AboutBuilding Permit Application (Rec Equipment) 1t-r:rN . 13 ~ JAiV NtJ l., City of Oshkosh ~ ' Inspection Services Division , POBox 1130 Oshkosh, WI 54903-1130 '~Phone: (920) 236-5050 Fax: (920) 236-5084 Building Permit Application. ON THE WATER [(vou are a contractor particiTJatinf! in the Permit Fee Account Svstemand have adequate (unds. check her(; ifvou want this processed throuf!h your account n ;. -,.'. '.-. 9/f";-/hf'Lfi...':s" r;" .;; .' ',7:'-~';::'.'~",::::;','._";.. . . ,scf..h2~:' . '. :.,' O~"ER .. :'-:''',,' ," ....., ^' ~ ~ ~.... . .-....-..- . . . USE CATEGORY DSingle Family ODuplex Work being done:' ." o Addition .,-' '"" - ", .- -'., - ,., .-" .... ....... [] StOYejpir~~ '.. . .'. ........... .."r."", .... i. ." ;:'::;~\\;f\7g:I'1'Ee.EI'VE'm'. .. ~ Other c'nl ?'L~ . .. . . <:J\:':~'\'I;:>~fk5f~M/:,i"iif:' Additional information, such as plan submittal and appr~~~Inay~e req~ire'b~~fore issuance. .FJiers; . '. .... located in the hallway, may be referenced to note if ~nyadditi~n~~'a~~T~~~~ L .. . .' .' . .><-,' . ..,I9N SERVIC~S DIVISION .:. Fulldescnption ofworkbemg done: . .. .... . '. "'JLi> .,1.. Ii J. '. . f2..~b kill- '~SiT:>'i-.,)d-t-i-,' 'f/c &'0'" .' ,;':">;r:I"~;I..:i. ..... o . ;J;$~<::.L ~;'d 8~ ,IV '~'Y'f:\'...".'.Rfjt<):'i"Pf=/i17--0 I :i,. /Pi171c:tI"f.:6.' '.. ,,",-' ~- .:;.....-. '. _.-~ . ,_'_,-,";" ,..,., ~ . - . Any work not included in this application isnotpeTmitted~ . i ~..i)' I.' . , , _;' ", ' '_ _ , ' _' ~: . ~ ' :.! . ~:' ,'I': ~ .-:: Value of the job $ . 'lobe; ,~ (V;Uue for materials ~d laborisrequired to ensurec~istencyin a~~~si~gPermit}eesfo~all I." .'. . applicants.) ': .'. .- ;,"'. " . u', . ,_:"f.':'~.;'if-Yj):" -.,.:..._::~-..~.;:":",~/,_;:-\' ,nY' ~-'_, ~ "'-d" " .. .'. ::;::'-">~:-:.' :->:: "'_. . -. .~,.,J_'.:-:_:~::_/:~,:7_~'~~ . 'PLEAsEREAD.'SIGN.&DATE:.:. .... _ .........:-....._u............, .u......~_._. ...~...>c..,..:.::........ .... ....... U .....:-.,)./.::ru,:.~-u... . dcertify the. above info17J1,ation iscompleteand accurate: Any deyiationsfrom the abovesubmitted.><> . infonnation may requireadditionalpermitsto be obtained. '1 acknowledge and ag:ee to these tei1:ni. ~, _ ' i. ,~ -. _~ :'_"".~: . Niiri~~-0ih~;:'~']) ~ t:H_c .........x:).L>:, :.. ; (. Fr/c-i:?7 l1/~~~' (P.l~~~.' t..c.:to~. ' . .*^.~ I "', l~. . SIgnature: .f/. ~.,."...~ ~ ~Y7' .V-- -- . 1'. !J ..,...,:.,....;.-.-' '-", 3/02.d.