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CITY OF OSHKOSH N° 38398
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 1 DW W/iEAfr/ ,Eu Wi tfV1 *IF PLAN NO.
OWNER ELISQ4 COAS77?L
DESIGNER /u /A
USE /NATURE OF WORK NEW S 63t.r 7 /��J /L IQ7�C. u 6
J
BUILDING CONTRACTOR R)SC
Size 6gr Sq. Ft. 9 Rooms 6 -Styr Storie Height 7
K
Foundation Class of Const. c'S Occupancy Permit
HEATING CONTRACTOR G1i
Heat A/C Vent Fuel/System Heat Loss
BTU'S
ELECTRIC CONTRACTOR 0
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR H
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
COO
FEES: Valuation Ay Permit Fee Paid Park Dedication r�°
g/9 7 9y
ISSUED BY 14J �I Date Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE Q �1.--..
3 g/g
AGENT /OWNER f
DATE
ADDRESS
TELEPHONE
CO 44- qq( B 03\ I g
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations BUILDING PERMIT C
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)
rosion Other:
Own s Name n Mailing Address Telephone No. (include area code)
c 2�1 ZQ Lti.fa r j c2V -8263
Contractor's Name Mailing Address -.4*----_ Telephone No. (include area code)
::O�L�..:. Q
p i 125 Sq. ft. 1/4, 1/4, Section T N, R E (or) W
Building Address /3 Subdivision Nam Lot No. Block No.
Wa 138
Zoning District(s) w Zoning Per F Rear Left Right
Setbacks ft. ft ft- ft.
w ew Repair ingle Family Entrance Panel n orced Air Furnace Nat. L. P. Oil Elec. Solid Solar
❑Alteration ❑Raze ❑Two Famil Size: a Fuel
Y I p Radiant Baseboard or Panel Gas
Addition Move Garage Servi e: Heat Pump Space Htg
❑Other (print): R16derground ❑Boiler
Overhead Central Air Conditioning Water Htg
El Other Other Dwelling unit will have 3 kilowatt or
more installed electric space heating
ate Constructed P e eat ng equip.
ONION N%•: Infiltration control
Manufactured Koncrete
asonry
option is: ❑Full sealing
❑Treated Wood Sew r of joints. Blower door test. Exterior
air infiltration barrier.
Other un icipa l
Unfinished Basement S ft. >i
Sq.
Stor
❑Septic ::Miii'� M4.. 10 5t
Permit No.
Living Area 1 Sq- ft- 2-Story S onal �t.e 7 Envelope f BTU /HR
1 �!�A:7:; %;i:: <c y ;:i Infiltration B T
Garage q�d g ft Other ermanent o ,255 U HR
q
unici al Utility
0
Other P
Basement Private On -Site Well i /v, 000
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 ime rt nt or municipality; and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE v L---- DATE SIGNED 3
APPROVAL CONDITIONS This permit is issu'f;d pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalty.
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Name iii<:i:z
Plan Review 40. a) p f onstruction
Inspection HVAC
Wis. Permit Seal Cr..' Electrical N C I Other Plumbing Date I
E 1 nb
Total o rosion l 6.0%
Cert. No.
SBD -5823 (R. 07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
31,Fres 1/$—cc°
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION) i/Ak A Gci Tab Wy ZONING
PROPERTY OWNER/CONTRACTOR: DOS1( CDOS
CONSTRUCTION DATA: New Construction Addition Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.)
Nad
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COMPLIANCE CHECKLIST rpoSE ��E9 C61 7 `-)r
DEFICIENT COMMENTS
I
Use
Lot Width
Lot Area
Lot Area Per Family
Floodplain
Front Yard
Front Yard Side Street
Rear Yard
Side Yards
Building Area
Parking Standards
Off Street Loading Standards
Vision Clearance
Transitional Yard Standards
Landscape Standards r/6
2--X
Height
Conditions of Approval
Compliance with P.C. or
BZA Conditions of Approval
Signage Standards
Drainage Plan
REVIEW AUTHORITY
As per Section 30 -5 Enforcement of the City Zoning Ordinance, the Director of Community Development, or
designee, must approval 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.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Req 'red
REVIEWED BY A /7- DATE: S
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City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address 3C° JHETF76J t( J
Owners Name U.seg 0N LL'?70/v
Name of Subdivision 1✓V7LE7 6
Lot /38 Bldg. Permit g)1 37(s7
No. of Units
Fee Required iU)v
Fee Paid
/CO, ti
Owner's signature t Date 3
Inspector's signature y ro
g. Date 7 9
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
CATE 9/ 3 l
1
NAME WL Sc tI (AiSr7 ADDRESS
00 ESS
LOT 3R BLOCK WARD
5U80I V Iil 16fi1 r5A'L/7JS ZONE
STREET NO. LONER 7 Ez..A LO5 LOT DIMENSIONS
SIDEWALK EXIST YES 0 NO El
B U I L D I N G GRADE ELEVATIONS STAKES SET AT SITE 3 I cl 14- BY K o
FEE: $15.00
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.
09, 11944 ,r.