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CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
N2
31695
TYPE: BLDG 0 HTG 0 ELEC 0 PLBG 0 SIG~ONING CL FLOOD PLAIN
HEIGHT
OWNER
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PLAN NO.
ADDRESS
DESIGNER
USE/NATURE OF WORK
BUILDING CONTRACTOR "f::;. If
Size I 2... y:~ Sq. Ft.
FoundoUon "All:' cJ q,,- ic-a 17
Jei'l-FL r\.. f-
# Rooms # Stories
Class of Const.
Height
Occupancy Permit
4n
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 _DW _DF _ San. Sewer
_WC _FDr _SP _Ur _ Storm Sewer
_Sink _ LTub _ Eject _SS _ Water
Other
Paid $
Date
Park Dedication $
Final/O.P.
ISSUED BY
In the performance of this work I agree to erform all work pursuant to rules governing the described construction.
SIGNATURE ~~~n
ADDRESS 3 () (;) 5 K.o e I (~,.e
/;//7/f2-
/ DATE
;l33-,?3trtJ
TELEPHONE #
Revised: 8/89
ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: :300 ."SO k oelkr- ZONING;
PROPERTY OWNER/CONTRACTOR:
c~
CONSTRUCTION DATA:
ALTERATION PARKING LOT
-
NEW CONSTRU~ _ADDITION
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence. pool. sign. deck. etc.)
12-~~ I/!!?WU'~. z:dJ..f(J 5:3"" 1)"-. ~~
COMPLIANCE CHECK1.IST (Check only those applicable)
DEFICIENT
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (fraTt yard)
Rear Yard
Side Yard (R)
Side Yard (1.)
Parking Spaces
Building Area
Lot Area Per .Fami.1y
Corner Lot
Landscaping
Transitional Yard
.
Off-Street Loading
Vision Clearance
Height
DEFICIENCY/COMMENTS
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R IEW AUTHORITY:
Th, Director of Community Development, or designee, must approve all plans, except the
forlowing: (1) Alterations or interior work when the use is conforming and when no change
in use is proposed. (2) t"aintenance items,. e.g. sid.ing, windows. etc., when the use is
conforming and when no change is proposed.
Instances where work complies with the above criteria, the permit can be reviewed by the
Building Inspector withou~ referral to the Director of Community Development, or designee.
~ROVED' . DENIED
Plan Commission Action Required
Variance(s) Requir
REV I E1JJED BY:
DATE: