HomeMy WebLinkAbout0017964-Building P I CITY OF OSHKOSH N9 17964
0 PERMIT APPLICATION AND RECORD
TYPE: BLDG, HTG ELEC PLBG SIGN ZONING S.--- FLOOD PLAIN- EIGHT,•Ce
ADDRESS r -3- 14..k.. a r i^ 1 7 (6-,e--42._. PLAN NO.Q C
OWNER cam. /L.e rs C (1 cta, S�
DESIGNER
USE /NATURE OF WORK w i ck'
BUILDING CONTRACTOR
1C�� Sq. Ft. l 1 Rooms r� k r' Stories Height
Size
Foundation cA../ �,j Class of Const. CF Occupancy Permit
HEATING CONTRACTOR
Heat A/C Vent C Heat Loss BTU'S
ELECTRIC CONTRACTOR l �r
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
I/
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation G
Pe Fee Paid ...r....40 Park Dedication
ISSUED BY III �i i/ Date Final /O.P.
In the performance of ork I a o perform all ork pursuant to rules governing the described construction.
y
SIGNATUR Y� G /5t1'
AGENT /OWNER f DATE f/
apc- ADDRESS cgc `O' /V v S'-f�` /1.. U -'�S3 �O
TELEPHONE
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: I'S ZONING: ?.S
PROPERTY OWNER /CONTRACTOR:
CONSTRUCTION DATA: NEW CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
c.o t1 e d(
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
i Floodplain
Front Yard
Side Street (front yard)
Rear Yard
Side Yard (R)
Side Yard (L)
Parking Spaces
Building Area
Lot Area Per Family
X/ Corner Lot
cti Landscaping
Transitional Yard
Off Street Loading
Vision Clearance
Height
REVIEW AUTHORITY:
The Director of Community Development, or designee, must approve all plans, except the
following: (1) Alterations or interior work when the use is conforming and when no change
in use is proposed. (2) Maintenance items e.g. siding, 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 without referral to the Director of Community Development, or designee.
GPPROVED DENIED
Plan Commission Action Required
Variance(s) Required o
REVIEWED BY: /It DATE: Y�
DATE y
NAME 4`t ADDRESS
LOT BLOCK WARD /j
S UBD I V /n ,f„ ZONE
STREET NO. ,/1 /4•C.ti LOT D I MENS I ONS /2
SIDEWALK EXISTING
C-7" ES
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 4/5 ,19 9 BY 0
FEE: /5.00
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above de -ribed probe y agree to have the
grade established before excavation has come,
04122