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ZONING/LAND USE COMPLIANCE CHECKLIST
I. GENERAL
Building Permit Zoning /Z'3 Conforming Non Conform
Job Location VaCC1. i19.11 W. Dimension
sion
Property Owner ice+ 1L� Lot Area
II. CONSTRUCTION DATA
Descrie Work:
1/04-‘4.
NENCOMSTRUCTION ADDITION ALTERATION
Accessory Building Pool Single Family
Fence Deck/Patio
Two- Family
Boathouse Sign MUlti- Family
Utility Structure Porch Commercial
Other (specify) Manufacturing
III. COMPLIANCE CHECKS
Deficient Deficiencv/Comments
Use
Lot Width
Lot Area
Floodplain
Front Yard
Rear Yard
L,,' Side Yard (R)
Side Yard (L)
v
Parking
Building Area
lot Area per Family
Corner Lot
Other (specify)
IV. REVIEW AUTHORITY
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 no change of use is proposed. (2) Maintenance items, e.g., siding, windcws,
etc., when the use is conforming and when no change of use is proposed.
Instances where work complies with the above criteria, the permit can be reviewed
by the Building Inspector without referral to the Planning Director.
APPROVED NOT APPROVED
Plan Commission Action Required
Variance(s) Required
REVIEWED 7/ ,40.41r SAS—
ONE TWO- FAMILY DWELLING Permit No.: rig `L O J
PERMIT TO START CONSTRUCTION j 3_8
Date:
FEE IN ADDITION TO PLAN EXAMINATION /INSPECTION FEES
OWNER STREET NO.
CITY /TOWN k STATE ZIP ELEPHONE
CDs 4Ico-�
n tAftS J 9 0 t' 144)235 &o3(;-.
DWELLINV LOCATION STREET NO.
1 ao9 m1\ w S:txrc6-1 P.
CITY /TOWN COUNTY
Sl-- f-eCa W 1 ■J/.JC(3 6, G.0
AGE CY (BUILDER, ARCH. O ENGR.) STREET NO
CITY l 'tf> z 1 t V S �d�
l�� Q g.1-4-- STATE ZIP TELEPHONE
l t-� V )7 S C444) 2 3 U C'
I, the undersigned, request to begin footing and foundation work prior to the approval of the plans and issuance of the
UNIFORM BUILDING PERMIT per Ind 20.09(5)(b)2.
I have reviewed the specific code requirements of the Wisconsin Uniform Dwelling Code, Chapters Ind 20, Ind 21, Ind
22, Ind 23, Ind 24 and Ind 25, as applicable and have shown compliance on the drawings.
1 agree to make any change required after the plans have been reviewed and to remove or replace all noncode complying
parts of the footing and /or foundations.
I agree to proceed with the footing and foundations only and will not continue with the remainder of the dwelling until
approval and a BUILDING PERMIT has been issued.
I also understand that prior to the start of any construction, a zoning permit and a domestic septic permit has been
obtained form the local authorities having jurisdiction in accordance with their laws and ordinances.
..itr ILA la`lb dp„
NOTE: Complete building plans are needed for issuance OWNER /AGENT S NAT RE
of this permit. Footing and foundation plans submitted
prior to final plans will not be accepted for issuance of Z 3/S
this permit. DATE
UNIFORM BUILDING PERMIT APPLICATION NO.:
ZONING PERMIT NO.: SEPTIC PERMIT NO.:
AUTHORITY HAVING JURISDICTION:
OFFICIAL Tom' TITLE
ISSUED DATE FEE RECEIVED DATE
13 e 21 3_g
NOT ISSUED BECAUSE:
DILHR SBD -6072 (R.10/80)
ISSUING JIM TrnTrrrTam
DATE 9� 9
NAME 4 f' Chi ADDRESS 42.:,:.:
LOT 3 OEM I R I BLOCK WARD 13
SUBDIV 1 4 0 F EE /4 0,,z T
z Z ti
ZONE
STREET NO. /a n 9 /a. 11/, S LOT DIMENSIONS
SIDEWALK EXISTING pek_r
YES C NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 5 ,I9 8S BY kW
FEE: $2.00
4
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
e2- XMAiy /7 Ced
4: 3300
WINNEBAGO COUNTY HEIGHT PERMIT
CITY OF OSHKOSH
f
OWNER:
ADDRESS: l- Orerinfl 2
TELEPHONE: 2 3 7 )3 r
ADDRESS OF PREMISES AFFECTED:
z_09 -12.1 1
HEIGHT OF PROPOSED STRUCTURE ABOVE GRADE: 1 R
COUNTY USE ONLY
EXISTING GRADE ELEVATION:
MAXIMUM ELEVATION ALLOWED:
APPROVED: YES Q NO [I
COMMENTS:
CITY INSPECTOR:
TELEPHONE: DATE:
COUNTY INSPECTOR:
TELEPHONE: DATE:
White copy County; Yellow copy Town; Pink copy -Owner