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35526
CITY OF OSHKOSH N
PERMIT APPLICATION AND RECORD
TYPE: BLDG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT�
ADDRESS 0 1 I(J L Os-x. r PLAN Nali B3 f
OWNER 'G'L- 2 P
DESIGNER
USE /NATURE OF WORK L Ari s r
BUILDING CONTRACTOR
6.7.,r—r—,`"6
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Siz Sq. Ft. --t /J Rooms Stories Height
Foundation dortk �P� 4mt",!' Class of Const. eF Occupancy Permi l
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
_Lay Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
i
FEES: Valuation g jp j i Permit f ee Paid /9. 4 Park Dedication
ISSUED BY i Date 2 Final /O.P. i./.2. 14111
In the performance of this k I agree t• perfo all work pursuant to rules governing the described construction.
SIGNAT �GC<Gf r 0 f
TN /OWNER J D E
ADDRESS 11 uJ I a,21/4-' 37I- a
TELEPHONE N
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Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations
Safety and Buildings Division BUILDING PERMIT
P.O. Box 7969 APPLICATION Parcel No.
Madison, WI 53707
Wisconsin Statutes 101.63, 101.73 (See instructions on back of pink copy)
girti#RMititttiOttridin
olConstr 0 HVAC 0 El ec 0 PI bg 0 Erosion 0 Other:
Owner's Name Mailing Address Telephone No. (include area code)
Ket-- d 0 0 6PW 9eXCeri 1()./t/Z-10 2- .5 C
Co acto N rtx Mailing Address Telephone No. (include area code)
ZtotPa.
i: Lot Area
I gl i i i Pitaierr i tOCATIONE
Sq. ft. 1/4, 1/4, Section T N, R E (or) W
Building AdOress, Subdivision Name Lot No. Block No.
2 L.1 4a_A 401C- C,171 Z--
Zoning District(s) ring Permit No. Front i ft
Rear Left Right
rz- Setbacks 2 ft. 61 ft. ft. /a— ft.
OS NatataiiiiiiingniiiiigaN!!!!ii:ili :Irkediiiimom Ettetruaravativelowtom iii:iiiiiiiiiiiii:ig
0
ew Repair ingle Family Entranpmel ler F
ced Air Furnace G N N. L. P. Oil Elec. Solid Solar
A teration 0 Raze 0 wo Family Size: W amp 0 Radiant Baseboard or Panel uel
El Addition 0 Move 0 Garage S2rvice: D Heat Pump Space Htg iti 0 0 0 0 0
0 Other (print): 0 .r.ftr nderground 0 Boiler
0 Overhead 0 Central Air Conditioning Water Htg D D 0 0 0
0 Other
7. Ze..i.*; INDATION: 0 Other 0 Dwellin unit will have 3 kilowatt or
more installe electric space heating equip
[3 Site Constructed
--i;., oncrete 10 PLUMBING Infiltration control option is: 0 Full sealing
2 msivetvotn fl Manufactured 8 rraesaozrdywood of joints. 0 Blower door test. fl Exterior
air infiltration barrier.
'Unfinished Basement 1 -.Slqcj. ft :!5 0 Other t-7 i •nicipal
)3 HEK:(C40:SC4gaiti4ataME
.1crStory :iieNUSEI:;::::i:i:ili:i.i:::::•:::i:i:i:i:::iii:iiiii 0 ptic
permit No. Envelope BTU/HR
Living Area i S Sq. ft. 0 -Story 0 Se- onal
11 WATEIC.::::::::::::::::E:.::i:i:::::0M::: Infiltration BTU/HR
O Other ermanent
Garage /1 Sq. ft.
0 Other unicipal Utility
114Vilttt.0000. 4. GigOS
tie
0 Plus Basement 0 Private On-Site Well
75
0"Z 0.00
1
The applicant agrees to comply with all applicable es, statutes an. e i I' ces and with the conditions of this permit; understands that the issuance of
the permit creates no legal liability, express or i/ o e D- pa7 or mu ipality; and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE
.i.- DATE SIGNED f r.i RI,
i may APPROVAL CONDITIONS his permit is issued pursuant to t,,,I following conditions. Failure to comply ma result in suspension or
revocation of this permit or other penalty.
.................0,41_, _he_ Yeap,...%.....- •41. 1--e u to pf.„0 70r1 ier .4 e ep .4 i i
4i [3 Town 0 Village Mity 0 County 0 State of: Municipality Number of Dwelling Location:
itiltiSOICEION'""'
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:::ii:;i:::::mi.::::::::mt:Ilignmi:::::::11:::::::::::::::ili: tsoto:iiiiiii::::::ilii;:ii: !:!:$0At.NOZ,:::::::;::iiiiii:::ii::!:!ii:;;E: iimmitimrlmimMI:iiili::::::::!::::ii,i;i::::::::::::!:::•:::::::::::ip::::::::::::::::1:::
Plan Review 5 1/ 0 .-i•-•.W onstruction
Inspection 0 HVAC Name I .1 4 f 4 f N
Wis. Permit Seal 30 [3 Electrical
vvAirir
Other 0 Plumbing Date
0 Erosion
Total 7'O n -''ilG -5/6 Cert. No. Z O
SBD-5823 (R.07/92) WHITE Issuing Jurisdiction YELLOW- DILHR GREEN Inspector PINK -Owner/Agent
6 s-
Revised: VS
ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: ;=7Q /4 10,'4,01-t_ ZONING:
PROPERTY OWNER /CONTRACTOR:
CONSTRUCTION DATA: NEW CONSTRUCT:10 ADDITION ALTERATION PARKING LOT
TYPE OF PROPOS5D CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
COMPLIANCE CHECKLIST (Check only those applicable)
CDMP!S DEFICIENT DEFICIENCY /COMMENTS
Use
Lot Width
Lot Area
Floodplain
Front Yard
Side Street (fro% 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
REVI A AUTHORITY:
The irector of Community Development, or designee, must approve all plans, except the
follo,ing: (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.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Required •1 v
REVIEWED BY: ��e. DATE: v AlI FF 3
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DATE 7
NAME 124./ AOORESS
LOT BLOCK WARD
SUBOIV. ZONE
STREET NO. 461/47 £r, LOT DIMENSIONS 7,5 5
SIDEWALK EXISTING YES 0 NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE BY
BY
FEE: $15.00
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree ro have the
grade established before excavation has commenced.
001.817
CATE 7 4 /73
NAME 1,2).enAl -694611) R ADDRESS
LOT .7 C S'mil /A& BLOCK WARD 4.2-
SUBDIV• ZONE
STREET NO. 2-o 4 ed, Za45 ac LOT DIMENSIONS
SIDEWALK EXISTING YES 0 NO
BU I LO I NG GRADE ELEVATIONS STAKES SET AT SITE 19 93 BY k/,,1
FEE: $15.00
4t///2) /fAx
DEPARTMENT OF PUBLIC WORKS
1, the undersigned, owner or agent of the above described property agree to have the
grade estaaiished before excavation has commenced.
OOE 3 413 iv