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N°_ 39268
CITY OF OSHKOSH
PERMIT APPLICATION AND RECORD
TYPE: BLDG V HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS PLAN NO.
OWNER Z DZ AO
DESIGNER USE/NATURE SE /NATURE OF WORK (sFiq 6 /ST/&6 PZLY1r /N6 SC.43 OA-)
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BUILDING CONTRACTOR L.-___
Size d Sq. Ft. O Rooms Stories f Height
Foundation ODAX.12.61i oC./C t� wACCS Class of Const. g Occupancy Permit_
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 CO Permit Fee Paid Park Dedication
ISSUED BY ��1��1,][�I� Date 5 /4? Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 5 t, 1-e_- -3--- 9
AGENT /OWNER DATE
ADDRESS >e) C,, S /�li.i_oi t9.,‘k4J-C11L1 i O) O(,
TELEPHONE
ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: qj 1,0/tub-ac s ZONING
PROPERTY OWNER/CONTRACTOR: r ,/)G
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CONSTRUCTION DATA: New Construction Addition Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.)
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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.
4/APPROVED DENIED
Plan Commission Action Required
Variance(s) Requir-d
REVIEWED BY DATE:
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