HomeMy WebLinkAbout0039487-Building (I
CITY OF OSHKOSH
39487
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBG SIGN ZONING I FLOOD PLAIN HEIGHT
ADDRESS l T'? t2 w14. ea l�C -`a- PLAN NO'S 7' -C F
OWNER 'S C- k 0.4241-t 4`v-G ll.l>rv vk
DESIGNER
USE /NATURE OF WORK �C'c c.. S r /e- a/ /1--*‘ a9- a-
BUILDING CONTRACTOR S% C
_I Cre=-►+,p,.t 1° t
Siz Sq. Ft. 1 %ti`vF Rooms C,e`F"e-Pa Stories Height Foundation g �ir- �,4h.P.� A Class of Const. 6 Occupancy Permit t
HEATING CONTRACTOR
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New Change 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 0 .!_tt# Per i ee Paid 0 Park Dedication /fib
ISSUED BY 0 L. �.�ii Date ..S Final /O.P.
In the performance of this work I agree to erform all work pursuant to rules governing the described construction.
SIGNATURE geb YIN� 6/7/0
AGENT /OWNER DATE
ADDRESS
TELEPHONE
5
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations BUILDING PERMIT
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)
PERM.T REQUESTEIr3 >m
im Constr ErFIVAC Q'glec gill eirosion p Other:
Own A 0...-11 Mailing Address Telephone No. (include area code)
C�m ,(2,1. 0 60 taxaSov.) 21 2 --Szo3
Contractor's Name Mailing Address Telephone No. (include area code)
Lot Area
Q 2� 5 Sq. ft. 1/4, 1/4, Section T N, R E (or) W
Building Address r Subdivision Name „r__, iailda_i .7Lot No. Block No.
i di i a1
Zoning District(s) Zoning Permit No. Front Rear Left Right
Setbacks J s ft. I 7,i ft. /6 'S 1 ft. /6 1 ft.
R .::�:t ::;:.;ma�yy;: :r!� /Y±y'�y��� tp
.�r... F� x... .Y.�J�. %ii i .t: :Y��.� a, .kF':FR1�1�:7:�ikiiiii i�:X'�iiE7R��Wia:i��J1Jil.
C ew Repair C Ingle Family Entrance Panel C orced Air Furnace Fuel Nat. L. P. Oil Elec. Solid Solar
Q Alteration Raze Two Family Size: 100 amp Radiant Baseboard or Panel Gas Y°
Q Addition Move Garage Service: Heat Pump
Other (print): underground Boiler Space Htg El
Overhead Central Air Conditioning Water Htg 0
Other Other ❑Dwelling unit will have 3 kilowatt or
more installed electric space heating quip.
ite Constructed oncrete g
:'��3 >3 In contro option is: Full sealin
Manufactured Masonry of joints. El Blower door test. Exterior
g
a w`:I<< ❑Treated Wood Sews,
i7 al air infiltration barrier.
>ST#�EEi Other unici P
Unfinished Basement 1 Sq: ft.
❑septic 13 C�i��hT.E0S$..�.�ii4�ic�[�:><`
®T- Story y::' a> US�.' E >z Permit No.
Area
1 36
4 Envelope BTU /HR
Living Sq. ft 2-Story Q Se onal
12 Other ermanent
:i' ATR z :in: <z Infiltration BTU /HR
Garage 53 S ft 9 q
ni i I Ili
1 u c a Utility
❑Other Y
Plus Basement Private On -Site Well 54060
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 implied, on the De artment or municipality; and certifies that all the above information is accurate.
APPLICANT SIGNATURE 7 iL De
DATE SIGNED S /s
APPROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may res in su ension or
Ad it revocation of this permit or other penalty. �Q
it 0.t h 12-o3't(ooL C ,t o-i'l st kek0— �Jsc_ c A 0 I Y-A k
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II II
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y —L1 6 PS'rati %S .5 G'e- Pr 1cr 1
Town Village it C ount State of: Municipality Number f 70 g y e o o Dwel Location:
Y Dwelling
R DICTION e)± 49
::::::::::::::::::ft
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Plan Review 46 d onstruction
Inspection VAC Name `I.4,
Wis. Permit Seal ZU 0 Electrical
Other Plumbing Date .O
❑Erosion fir
Total 7 OS 3 Cert. No. t7-a 'j47
SBD -5823 (R. 07/92) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
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ZONING /LA UOREX NDUSE COMPLIANCE CHECKLIST
1
JOB LOCATION: t LA L tt a> W7 ZONING
PROPERTY OWNER/CONTRACTOR: f Q&\
CONSTRUCTION DATA: New Construction Addition Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.)
P\2)3 �,i, e l AITA GiN2Aez„
I
COMPLIANCE CHECKLIST
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 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: f'
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City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address /45 te) c a Fet, slaV
Owner's Name s e eoka' IC.
Name of Subdivision bil es-e 4
Lot ?e Bldg. Permit Ilr .39 -4/8-7
No. of Units
Fee Required loQ
Fee Paid
C7
Owner's signature G�.._ D. 9 f D e o
Inspector's signature AO/
t :te eo F
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
GATE S�/ �1 Q�
NAME usc.1�1 51k'uCr/o
ADDRESS
LOT q0
BLOCK t
fARD
suso I v WGSTLE7(6 F/21)15 ZONE
STREET NO. MO (N 4 7 Z b
LOT DIMENSIONS
SIDEWALK EXISTING YES 0 NOEj.
BUILDING GRADE ELEVATIONS STAKES SET AT SITE
9Y
FEE; $15.00
/YelJf'C/‘A
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.
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