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CITY OF OSHKOSH N°_ 32346
PERMIT APPLICATION AND RECORD
TYPE: BLDG kf HTG ELEC PLBG SIGN ZONING lam-'/ FLOOD PLAIN HEIGHT
ADDRESS Z 7-3 PLAN NO. 1/030/
OWNER
DESIGNER
USE /NATURE OF WORK 7l.(„) 1,/e a,
BUILDING CONTRACTOR 6 !r•��✓ L �4YL
p� �3/
Size ri
Sq. Ft. 9 ��0 Rooms 5- 7-4 1 1 Stories Height 7
Foundation lam"' Class of Const. 0 Occupancy Permit
HEATING CONTRACTOR AttiV
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR fi.G(./r7
Electric Serv. New Change 0 Temp 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
FEES: Valuation 30) 000. 0 D Permit Fee Paid /M Park Dedication l0-0 OD
ISSUED BY ZL Wit." Date 143/1- Final /O.P. IP /2 el 93
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
_tql 7
SIGNATURE 7 k. I
AGENT /OWNER D ATE
ADDRESS
TELEPHONE
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: /2 3 .J. /,r�,�, ZONING: /2
PROPERTY OWNER /CONTRACTOR: it 1
CONSTRUCTION DATA: J NEW CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
f e
r
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (front yard)
Rear Yard
Side Yard (R)
Side Yard (L)
Parking Spaces
Building Area
Lot Area Per Family
Corner Lot
Landscaping
Transitional Yard
Off- Street Loading
Vision Clearance
Height
REVIEW AUTHORITY:
The Director of Community Development, or desi ee, ;us /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.
/.APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED 8Y: G" DATE: I
H i o 3 o i 93 IC
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor Human Relations BUILDING PERMIT 23
Safety and Buildings Division
P.O. Box 7969 APPLICATION Parcel No.
Madison, WI 53707
Wisconsin Statutes 101.63, 101.73 (See instructions on back of pink copy)
ED' Constr HVAC Elec Plb
9 AErosion 0 Other:
Owner's Name Mailing Address Telephone No. (include area code)
,23/— no3
Co tractor's Na e Mailing Address Telephone No. (include area code)
Co
,27 0 zeizi molk- lCd /9 SP O 511 3333
e Lot Area
1 1 ie 4� Sq. ft. 1/4, 1 /4, Section T N, R E (or) W
Building Address Subdivision Name Lot Lot No. Block No.
Zoni DD o ning Permit nt I Rear Left Right
ie' i Setbacks i e 9. ft I ft
6iiiii.^ isiL ?i:iiii:! iti:ii}}ii ji '!i:: .i .i' �mm.i:::: :.v..:.:.: :��•:TV:;�.�..}_..;
:y ft. a .}'.�::::.p:;T.. r:::::. L::<:: i:: i:: iii?:: ::i:• ".::•ii::i::i:::::i:: i�:
TT�� iEE'#' iii moccup�x.:.; E� EC lilai HVA "::E I t ENT::<: ::12.: y�am{ E i
New Repair Single Family Entrance Panel *Forced Air Furnace Fuel Nat. L. P. Oil Elec. Solid Solar
Alteration Raze Two Family Size: /0 0 amp Radiant Baseboard or Panel Gas
Addition Move Garage Servi ce: Heat Pum
Other (print): Underground Boiler p Space Htg
Overhead 0 Central Air Conditioning Water Htg
Other
Other Dwelling unit will have 3 kilowatt or
more installed electric space heating
Site Constructed Concrete p eat g equip.
'tOi::P� M:BJNO:ii:#:iiiiii:z� Infiltration control
anufactured 1Aasonr
option is: Full sealing
'x: of joints. ❑Blower door test. ❑Exterior
>i:`.i> Sewer
❑Treated W oo d
e
air infiltration barrier.
O RIES .ii: ::ii .i•. Other unici r..
Unfinished Basement /L Sq. ft.
p S eptic ':ICHE ttT OS",s;::: rti! c? #etnn....
9 �SO Sto ry s i'•'•SEi >i >''ii`•ii %a
Permit No.
Living Area S ft. Envelope o13 �e 7� BTU/HR
2 -Story ❑Seasonal p
t'' Q »i E >i Infiltration 3 5 BTU /HR
Garage T Sq. ft. Other Permanent rP 7
Munici al Utility STx:>: 0�:_` ;.•.•,�•»,�'�iz>::i:i ?<'rii >ii:
Plus Basement Private On -Site Well 1, O }Q OD
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; understands that the issuance of
the permit creates no legal liability, express or im lied, on the Dep ent r municipality; and certifies that all the above inform tion i accurate.
APPLICANT'S SIGNATURE mss-- DATE SIGNED /'g 93
APPROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may re It in suspension or
revocation of this permit or other penalty.
Town
Village e
Cit
County of: 9 Y o Municipality N
Y t umber of Dwelling Location:
Plan Review 40,0 0 Construction
Inspection HVAC Name 4�,..7t/
Wis. Permit Seal 3 0. 0 O Electrical J I (`4 C 3
Other [2] Plumbing 7 7 a Date ///3 ri4
Total 7 0 O o Erosion
Cert. No. c255
SBD -5823 (R.07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
3o K
tel knaii
I HIGHEST
POINT
!X
1�i r 'f' I
1,1‘)/ I W 1
I
107-97
00'-97 I
,�y I
PC x
3 I
1 1 1 I x xxx
STRE ar� ID
OWEST
POINT ID STRAW BALES
X)OC FILTER FENCE
PROPERTY LINE
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address J Z 43 Aiii.iyalf/d7-
Owner's Name
Name of Subdivision 4/,
Lot 2f l dg. Permit 323'14
No. of Units
Fee Required /00 o
Fee Paid a 0. 0
Owner's signature f2J(/1 Date 1 I q q3
Inspector's signature v Date /3/93
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
CATE l /3 /9 3
NAME 1 441t 6 ADDRESS
LOT o t BLOCK WARD
SU801V. ZONE
STREET NO. tAA3 t LOT DIMENSIONS
SIDEWALK EXISTING YES NO ET
BUILDING GRADE ELEVATIONS STAKES SET AT SITE I I S 199 3 BY K.
FEE; $15.00
DEPARTMENT OF PUBLIC 'WORKS
1, the undersigned, owner or agent of the above described property agree ro have the
grade established before excavation has commenced.
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