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35047
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
~~P_E~ _ _ ~L~~ ~ _ ~T~ _ C? _ ~~E~ _ C? _ ~~B~ _ C? _ ~I?~ _~ _ ~O_N~N~ _ _ _ _ _ _ _F~~~D_ ~~I~ _ _ _ _ _ _ ~~I~~T_ _ _ _ _
::::ss.;:: ~~ PLAN NO
DESIGNER
USE/NATURE OF WORK ,47Jz
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BUILDING CONTRACTOR a _~ &A- dvcIA.--
Size 1"2--'11 t..- Sq. Ft. I '-I '-f
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# Rooms
Foundation
Class of Const.
# Stories
~
Height
Occupancy Permit
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HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
BTU'S
ELECTRIC CONTRACTOR
Electric Servo
New 0 Change 0 Temp 0
Type ~ Volts _ Amps_
Fixtures
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR
_BT _WH _Disp _ WSoft _ CBasin
_Lav _Sh _OW _OF _ San. Sewer
_WC _FOr _SP _Ur _ Storm Sewer
_Sink. _ LTub _ Eject _SS _ Water
Other
FEES: Valuation $ ?..to!r. 0 0
ISSUED BY ~~ (~.
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Permit Fee Paid $
Date
?-c. 0 a
i /~ '3.,4-"??
Park Dedication $
Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
~~ .
SIGNATURE
, . . . r '6' AGENT/OWNER
DATE
ADDRESS
TELEPHONE #
Revisai: 8/S9
CONSTRUCTION DATA:
ZONING:
ALTERATION ---?ARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fencs. pool. Sign~c~ etc.)
12-)(';? ~LJ~
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT
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Use
Lot Width
Lot A1"9a
Floodplain
Front Yard
Side Street (~~)
Rear Yard
Side Yard (R)
Side Yard (L)
Parlting Spaces
Building A1"9a
Lot A1"9a ~er Fami.ly
Corner Lot
Landscaping
Transitional Yard
.
Off-Street Loading
Vision Clearance
Height
DEFICIENCY/COMMENTS
REVIElA AUTHORITY:
The Director of Community Development. or designee. must approve all plans. exceo~ the
following: (1) Alterations or interior wor\< when the use is conforming and when no change
in use is proposed. (2) t~aintenance items, e.g. siqing, windows. etc.. when the use is
conforming and when no change is proposed.
Instances where wor\< complies with the above criteria. the permit can be reviewed by the
Building Inspector without ref~rral to the Oirec~or of Community Development, or designee.
/' APPROVED
Plan Commission Action Required
Variance(s) Required
REVIE'~ED BY: ~LM///~
DENIED
DATE: ~h 7h?
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Archadeck of the Fox Cities/Telephone (414) 231-7476/(800) 653-DECK (3325)1Fax (414) 231-7636/P.O. Box 753/0shkosh, WI 54902