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"NAMED
ADDRESS
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LOT \?:,"'6 BLOCK----
SUBOIV}JICoLET Af0cj..tOOA~~ ~A-O()NZONE t
STREET NO. 87.s- )-/<>Jl.(.rl/;e"T,OT~~E~SIONS~)'~
YESD ~ .'
8~z..e ,19 act
~~AN,J
DATE
~.JARD
SIDEWALK EXISTING
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
ByKN
FEE: $2.00
blr~
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above descr[~ed property
agree to have the
3189.
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Zul
ZONnJG/LAND USE COr-1PLIANCEcaECKLIST
I.
GE:NE':lW..
Building Permit # zoningk:c-CfS Confonning_ Non-COnfonning_
Job Location _gc; S.I-(~Q.~~\/ifE0j C::t: Lot Di.Irension t42.(t~,,"ULt\fL
Property ,~Ou.t;J ~MAJ-J Lot Area
(0 ! A TT AC?l Kfj
I
6 A/~-<-
II. ' CCNSTRt:CrIOO DATA '
Describel'brk: ./0C(.....J ' ~ So (~
NEW CONSTRUCI'ION
ADDITION'
ALTERATION
.;~
_ Accesso:r:y" Building
Fence
Boathouse
__ Utility StructUJ:.'e
_, other (specify)
III. CPMI?I..IAN<:e' alFCKS."
Pool
Deck/Patio
_ Sign
Porch
_ Single Family
_Two-Family
_ Multi-Family
Canrercial
'___ Manufacturing
Complies Deficient
, Defici~ncy/Comnent:s
~
~
,K:"
k>
Use
tot Width
Lot Area
Floodplain _
Front Yard
Rear Yard
Side Yard (R)
Side Yard (L)
Parking
Building Area
Lot Area per Family
Corn~ Lot
other (specify)
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2$2.
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IV ~ REVIEt'l AUl'HO~
The Planning Director, or appropriate designee, must approve all plans, except
the following: (l)Alteratfons or interior r,.,prk ,when the ,use is confonning and
when no change of use is proposed. , (2) Maintedmce i teJDS,e. g. , siding, win~vs,
etc., when the use is confonning and when. 00 change of use is' proposed.
Instances" where work eottplies' with '. the ~ criteria,' the permit can be reviewed
by the Building InspeCtor without :referral to the Pl~ Director.
APProVED
~, APProVED
Plan Conmission .,Action ReqUired
Variance(s) Required
~FN:.4.?~
DATE: t '- ;zr"' ~r
State of Wisconsin
Department of Industry,
Labor & Human Relations
Division of Safety & Buildings
Box 7969
Madison, WI 53707
Wisconsin Statutes 101.63, 101.73
WISCONSIN UNIFORM
BUILDING PERMIT
APPLlCA TION
APPLICATION NO.
(See Instruction on back)
PARCEL NO.
~VAC
~EC
....ol'LUMBIN6
c: Telephone
4-(<{" -ZS~-" ZB7
Telephone
AP~LeTC>~ 9-iftl';- 4( - 73cf-:?3ol
Yo, SECTION , T
Lot No.
~C("k~RA~e. 61 A-DPN 1 '3 :$
Front Rear Left
"30 ,€f
N, R, E(orlW
Block No.
'-
Basements
Living Area --1'~
Garage
s-Y~
Sq. ft.
The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and'other Muncipal Qrdinances and ,with the conditions of this permit; understands
that the issuance of the permit creates no legal liability, e press or implied, on the Departmentor Municipality; and certifies that all the, above i formation is
SIG~A TURE OF APPLlCANT~'
CONDITIONS OF APPROVAL
1,.0
DATE
'8
pursuant to the following conditions. Failure to comply may result in suspension or revoca-
r other penalty.
Z'b
Plan Revi
Inspection. . . . . . . . $
Wis. Permit Seal(s) . ',' $ "3 ()
Other. . . . . . . . . . . $ , DOther
TOTAL. . . . . . . $
,DILHR-SBD 5823 (R:1/82) WHITE - Issuing Jurisdiction
Q.q~'87
NAME E '~(MR.t<-
a-C--~'t
DATE ~( \0,) Co)
CERT. NO. 0 [34 b
YELLOW - DILHR
GREEN - Inspector
PINK -Owner/Agent
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OWNER(:1'A,1L ~ ADDRESS rf7s:: ~ C~-'-
DATE f-~- r#. P, EllMI'1' # ~; USE. crrr2-' . ..'
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MASoN · CqN'l'RAc'1'OR - ZONE ~. '. .
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Width jOf lOt2=~ b3. A'1'V6t;OOD
,
. allot
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INSPECTIONS
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