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CITY OF OSHKOSH N° 33826
PERMIT APPLICATION AND RECORD
TYPE: BLDG X HTG ELEC PLBG SIGN ZONING 0 FLOOD PLAIN HEIGHT
ADDRESS /ZeP 7 GC/Q�f PLAN NO. P I 7 Z'OSq� n-
OWNER
DESIGNER
USE /NATURE OF WORK Yleui
BUILDING CONTRACTOR ject.41-e.4- L
Size Sq. Ft.1(0 3 Rooms (0 Stories 64.4..A-4 Height Zc
Foundation �.m� Class of Const. Occupancy Permit
HEATING CONTRACTOR se.G111.Glil
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR d
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR /If 1Cr
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, 0 OO, O a Permit Fee Paid 10 0 Park Dedication 434 .Oct
ISSUED BY Date 5713193 Final /O.P.
In the performance of this work I agree to erform all work pursuant to rules governing the described construction.
SIGNATURE
AGENT /OWNER DATE
ADDRESS
TELEPHONE
3 3 Revised: as
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: /2-0 W i,cZONING:
PROPERTY OWNER /CONTRACTOR: C
CONSTRUCTION DATA: „AIN CONSTRUCTION ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
A
COMPLIANCE CHECKLIST (Check only those applicable)
CDM IES 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 de gnee, st 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.
�PPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: DATE: 577l
J b 1 7 o c t
Wisconsin Department of nd WISCONSIN UNIFORM Application No.
Labor and Human Relations BUILDING PERMIT 3392-6
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)
PER IT
C onstr HVAC Elec Plbg Erosion Other:
Owner's Name Mailing Address Telephone No. (include area code)
Contractor's Name Maili g Address Telephone No. (include area code)
1-76 v .i a- ;tozw(- Zee 2 -8243
:::ai Lot Area
....il!.i OJECIA .;.•.•..K•.:.'A'•.'•.'•:":`IONE Sq. ft. 1/4, 1/4, Section T N, R E (or) W
Building Address Subdivision Name Lot N Block No.
Zoning District(s) Zoning Permit Front Rear Left Right
X Setbacks ft. V
T ft. r ft. ft.
W 'a ?i:::i i5, :.i �f <i ?ii:3i:::: ?i; <Siia
:i•.::i iii:::::::: :i iii:::: ":t J ��1a ...i��y Ii:L:i::
•i�••: �wA AE.. A. :�..�I.Ik. 1iM'.
A.. Y $i t ..�b .Ju.
ew Repair P ingle Family Entrance Panel ,orced 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 Service: Heat Pump
Other (print): Jnderground Boiler Space Htg
O verhead Central Air Conditioning Water Htg El ID ID
Other Other Dwelling unit will have 3 kilowatt or
more installed electric space heating equip.
ite Constructed oncrete '•.'�0
�„�;,i Infiltration control option is 0 Full sealing
❑Treated Manufactured ]Masonry Wood Sewer of joints. Blower door test. Exterior
:,K•:.rl
i h r Municipal air infiltration barrier.
Unfinished Basement l� Sq. ft.
Ot a
Septic .Mi lrttiT�i�T�
1 -Story E: »i• Permit No. Envelope 5 BTU /HR
Living Area p0 7": S ft. 2 -Story Seasonal
41"`':'� Infiltration Z. S. 7
her ermanent,. BTU /HR
Garage S ft
Sq. 9 unici al Utilit
Other P Y ��5�x:: t_ s:l ii
Plus Basement Private On -Site Well J 000. D J ii
The applicant agrees to comply with all applicable codes, statutes and or antes and with the conditions of this permit; understands that the issuance of
the permit creates no legal liability, express or im t or municipality; and certifies that all the above informatio is act te.
APPLICANT'S SIGNATURE DATE SIGNED S
APPROVAL CONDITIONS This permit is issu`fsd pursuant to the following conditions. Failure to comply may resul in sus nsion or
revocation of this permit or other penalty.
4-' 3
L
Town Village it County State of: Municipality Number of Dwelling Location:
9 Y Y P Y 9
'2-- G 6
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Plan Review 40 to O 7Aonstruction
Inspection HVAC Name
Wis. Permit Seal 30, o 0 Electrical
Other Plumbing Date <��3
Frosion
Total 70.04 Cert. No. y T O
SBD -5823 (R. 07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
30
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STAE_ imEND,
11 STRAW SALES
POINT
)CO( FILTER FENCE
PROPERTY UNE
/.2 67 10
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /247/5e
Owner's Name e44.(4461-
Name of Subdivision A441-6rfr4,
Lot 33 Bldg. Permit 33.k2-C
No. of Units
Fee Required
Fee Paid C)(). 00
Owner's signature Date
Inspector's signature Date S1/2-/93
Parks Subdivision
Improvement
Accts. Rec.: 262-na7
CATE S/z 43
NAME iet.W e ADDRESS
LOT 33
BLOCK WARD
SUBDIV. Lj a._,z- ZONE
STREET NO. I Z47 (A) T i.d LOT DIMENSIONS
SIDEWALK EXISTING
YES 0 NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE r
19 73 BY
FEE; $15.00
44( ..s li si /e1•04*.V 0
DEPARTMENT OF PUBLIC WCRKS
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
OO,
14‘,6/1/