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CO ITY OF OSHKOSH N° 36892
L' PERMIT APPLICATION AND RECORD
TYPE: BLDG
N HTG ELEC PLBG SI ZO FLOOD PLAIN HEIGHT
ADDRESS f I I I I EW buy AN NO. 190 II /93R
3R
OWNER V 0 STRO O W
DESIGNER rr J
USE /NATURE OF WORK E 4.4: L/ L v r i.. j 4
BUILDING CONTRACTOR r 1 l
Size Sq. Ft. 1 aT Rooms 6 SSV Stories Height U
Foundation eauca�e�� Class of Const. g Occupancy Permit
HEATING CONTRACTOR Bl&LJ KI
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR QL! G IM /N6-s
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR Si
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 ap DaD Permit Fee Paid /OS' C:);) Park Dedication
ISSUED BY 4 _'.4 Date e f i S/ q Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE .1/14/1. /7 g
AGENT /OWNER DATE
ADDRESS
TELEPHONE
f7- /1)93R
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor Human Relations BUILDING PERMIT 3c9 oC'
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)
igi ;ii nstr E/ Plb oci I'�� sion
Owner's Name Mailing Address Telephone No. (include area code)
ao.rA eentat. c7( G� Roe., c 43/- Ra c53
Contractor's Name Mailing Address Telephone No. (include area code)
1 t
It i I Ik 1,
7 SCi Sq. ft
1/4, 1/4, Section T N, R E (or) W
Building Address Subdivisi n Name Lot No. 1 Block No.
L W °Lk74dd CI), tli-eatOiit) revviii4-7' 0 z/
Zoning District(s) Z g Permit No. F ront I Rear Left Right
Setbacks 2- ft ft. 6 ft. /0 ft.
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a y:
.an� A.�. 6 5 A III'.#:`. >:��iJI�EEI'wAt "t.:: >':0 .•.j<yj
7 ew Repair ingle Family Entrance Panel 0 orced Air Furnace Nat. L. P. Oil Elec. Solid Solar
Alteration Raze Two Famil Size: I(1O am Fuel
❑Addition ❑Move y P ❑Radiant Baseboard or Panel Gas I, Garage Ser ce: Heat Pump
Other (print): Underground Boiler Space Htg El
Overhead Central Air Conditioning Water Htg
Other Othe r ❑Dwelling unit will have 3 kilowatt or
't" ST...T .I! A'E'IION: more installed electric space heating i
ite Constructed oncrete P g equ p
3U BIN Infiltrati n n
❑Manufactured ❑Masonry' o control option is: ❑Full sealing
x' I:.D ❑Treated Wood Sew of joints. ❑Blower door test. ❑Exterior
air infiltration barrier.
Unfinished Basement��Sq.ft.
uniapal
❑septi Permit No.
c ::14005 I 446
d 1 Story ?3''
Living Area J 2-a 0 S ft. 2 -Story Se oval Envelope y� BTU /HR
Infiltration
ermanent i�>>::<: Z (f BTU /HR
Garage ✓2 8 sq. ft Other unici I .....::c. 1.:
Other Pa Utility
lus Basement Private On -Site Well 114 n in
The applicant agrees to comply wit 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 implied, on the Depart ent or municipality; and certifies that all the above informatio is accurate.
APPLICANT'S SIGNATURE 7 t DATE SIGNED
APPROVAL CONDITIONS This permit is issu'Isd pursuant to the following conditions. Failure to comply may resul n suspe sion or
revocation of this permit or other penalty
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2,) arc. 67105”. /0(0 /11easugE5 J,G /2 S'",
V ,M/ST C AS S1iJJAc 2YeAtA)<
Town
Village e
County u t State ate f:
of: Municipality
Y Number of Location:
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�T Ifs
Plan Review v1)* Go construction
____t_-ktt)-Z.S25--......,
Inspection l` HVAC Name
Wis. Permit Seal Electrical
Other
Ambing L l s' C� Date I l 111
sion
Total
$r 3/ Cert. No. yb
SBD -5823 (R. 07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner/Agent
tai a
II ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: ZONING
PROPERTY OWNER/CONTRACTOR:
CONSTRUCTION DATA: New Construction Addition Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.)
J\)j Cit-E 1M 1 Ai I'��C�C GiNzPrE
COMPLIANCE CHECKLIST
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DEFICIENT COMMENTS
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
Height
Conditions
nditions 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) Required
REVIEWED BY DATE: //95
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City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address 19ll NTF €Lt \J
Owners Name
Name of Subdivision V L\ Ltk
Lot D Bldg. Permit g6 W(9
No. of Units I
Fee Required C0 (n-)
Fee Paid e t/Of),
Owner's signature Date k
Inspector's signature
a Date 4
Parks Subdivision
Improvement
Accts. Rec.: 362 -041