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ZON1cdG/I~AI~ID USE COr'~LIADK~ (~~'CKLIST
I. t~L
Building Permit # ~ Zoning `( Confoxmi.ng Non-Confornting
Job Location ~ ~~ ~ ~ l ~ r Z ~ `~J"~I~ot Dimension
Property owne~-zU ~ C GGPM~~.I i ~(~(q.rJ~2lot Area
II. CCi~iSTRUCTIC~t DATA J
Deseri}~,e ~nbrk: ~~ .~ ~ J"" /~~~~ / Zr~Y)^~-- ~~ fit= ;2~~i~-
NF~n1 COKSTRIKTI~T ~ ADDITIC~T ALTERATI~T
i Accessory Building ~ _ Pool _ Single Family
_ Fence _ DeckfPatio __._ Tao-Family
_ Boathouse ____ Sign _ Multi-Family
_ Utility Structure _ Porch „~ Ca~mercial
_ Other (specify) _ Manufacturing
III. COMPISANCE CE3DC~S
Deficient Deficiency/C,anments
Use
_ Lot Width
v Lot Area
(./ Floodplain
v'~ Front Yard
'~~ ~_ Rear Yard
_~/ Side Yard (R)
~~ Side Yard (L)
~// _ Par,
/ _ Building Area
/~~~~Y Lot Area per Family
~/ Corner Lot
Other (specify)
IV. RE~TILW AUTI~RITY
The Planning Director, or appropriate designee, must approve all plans, except
the following: (1) Alterations or interior work when the use is conforming and
when nD change of use i.s purposed. (2) Maintenance items, e.g., siding, windows,
etc., when the use is conforming and when no change of use is proposed.
Instances where work oanplies with the above criteria, the permit can be reviewed
by the Building Inspector without referral to the Planning Director.
~~ APPRpVID NOT APPROVED
Plan Commission Action Required
VdrldriCe (S) RLgll].rEd
REVIEWED BY: ~`''~"'~ DATE:
DEPARTMENT OF INDUSTRY, LABOR AND HUMAN RELATIONS
SAFETY & BUILDINGS DIVISION
P.O. BOX 7969
MADISON, WISCONSIN 53707
PERMISSION TO START CONSTRUCTION
FEE REQUIRED IN ADDITION TO EXAMINATION/INSPECTION FEES
Location of Project:
Owner: iev~:1 ~s•:,~>r1`R-a I A I! i ~1r7c€~ E
Street: ___ iff~~ t°iifizei Av~nua Plan File Number
City: f~sllke~ch Date Plans Recd
County: '~inn~ha~o
Occupancy: `ahn~rr~-r~3 ~7~ ~lffic~
We, the undersigned, request to begin footing and foundation work prior to approval of the plans
Complete plans leave been submitted to the Department of Industry, Labor & Human Relations, Safety and Buildings Division,
and all information requested by Code Ind. 50.12 has been included with the submittal.
We have reviewed the specific code requirements for the building or structure including, but not limited to, Ind. 54.01, Ind. 55.02,
Ind. 56.02, Ind. 57.01 (construction, height and allowable area), Ind. 50.12, Ind. 51.03, Ind. 53, Ind. 55.05 and Ind. 54.50, when
applicable, and have shown compliance on the drawings.
We agree to make any changes required after the plans have been reviewed and to remove or replace noncode complying parts of
the foundation and/or footings.
We agree to proceed with the footings and foundation only and will not continue with the remainder of the building or structure
until approval has been received.
We understand that, prior to the start of construction, a Building Permit must be obtained from the local authorities having
jurisdiction in accordance with their laws and ordinances.
Owner's Signature Date
Accepted'By -" - Date
Name: Dev~~e{~a~+~~a ~A is i a+~s~
Address: _~~ z~~~
Dept. of Ind., Labor & Human Relations
Safety & Buildings Division
Not Accepted Because
-4s h Ir~~st~-~ i ~~4~ 1
r
%~~ Plans will be examined within the next
Designer's Signature {~~Date days.
Name: ~'Tft~s~ 1~ ~ar~#her
NOTE: Complete building plans are needed for issuance
Address:_~i ~-~1i~S#~i ~+~#'c~r~--~wA~,yt~ of this permission. Footing and foundation plans sub-
mitted prior to final building plans will not be accepted
- 9shkr~st~, '~tl S~I~A~ for issuance of this permission.
SB-198 (R. 12/81)
BLDG. INSPECTOR'S COPY
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