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CITY OF OSHKOSH N2-40958
PERMIT APPLICATION AND RECORD
TYPE: BLDG ti HTG ELEC PLBG SIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 4 4 W I NoI rk)G-Bzu314 IR,\vE PLAN NO. F IN 8Y W R
OWNER 1 t LO (J `S. VI SC'E'��._ QoI.)S"ZZs.s.5(1 •0:.
DESIGNER A 1
USE /NATURE OF WORK NElk) INC v11 (.–k_A 1k GAmQ
BUILDING CONTRACTOR INI –TDB Tj
lR
Size Sq. Ft. Dg Rooms 10 4 Stories Q Height 2 b
Foundation CRM� Class of Const. Occupancy Permit __C
HEATING CONTRACTOR M C.111
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR (V oRR\S
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 2 Now i. c_t
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr _SP Ur _Storm Sewer
_Sink LTub Eject _SS Water
Other
FEES: Valu Permit Fee Paid 3 sD V f CO
aa1� Park Dedication W
ISSUED BY 1 1 Date I t e
1 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATUR cr0eyw /M 7 ,77
AGENT /OWNER
ADDRESS4 71P// �i� Me /9AreA2 l c!; x/2.6 4967;50
TELEPHONE
O' Fa— l \c\' c4 R
1 Wisconsin Department of Industry, WISCONSIN UNIFORM BUILDING Application No.
Laborand Human Relations PERMIT APPLICATION Li DCt S
Safety and Buildings Division
P.O. Box 7969 (See instructions on back of pink copy) Parcel No.
Madison, WI 53707 The information you provide may be used by other government agency
Wisconsin' ;1(fi yte7 101.6 1 Q1 programs [Privacy Law, s. 15.04 (1) (m)].
PERM RE EST D; Cons J HVAC [0 E Iec E:1 PIbg Erosion 0 Other:
owner's Na sila 'j J M c ling Address Telephone No.
rAtt-To1V S. SeIA t `tan* 4 034 (yl4/ 9-30 -.0
Contractor's Name: Con KElec HVAC Plbg idCert Mailing Address Telephone No.
MORNS E 'g. c
Contractor's Name: Con Elec -IVAC Plbg ic/Cert Mailing Address Telephone No
MCM AR
Contractor's Name: 0 Con Elec HVAC Plbg ic/Cert Mailing Address Telephone No.
Contractor's Name: Con Elec HVAC 0 Plbg ic/Cert Mailing Address Telephone No.
�OECT L Oc 4T' N Lot Area
Sq. ft. 1/4, 1/4, Section T N, R E (or) W
Bu Idin Address Subdivision Name Lot No. Block No.
(43 W/ 4,86 il/6 SA
Zoning District(s) Zoning Permit No. Front Rear Left Right
I Setbacks 7 ft. I v0 •3 ft. /4/ ft. 14/ ft.
V O :AN
A )I"QPItiI`...... M;•: rligit.> IsfttottItt: >:'ii: >:'s::
New Repair Single Family Entra Panel V. orced Air Furnace Nat L. P Oil Elec. Solid Solar
111 Alteration Raze Two Family Size: �C0 amp •adiant Baseboard or Panel Fuel Gas
Addition Move Garage Service: Heat Pump
❑Other (print): A,Under Boiler Space Htg El
❑Other ['Overhead Central Air Conditioning Water Htg
Other Dwelling unit will have 3 kilowatt or
N mare installed electric space heating a
quip
Site Constructed Concrete P g q p
Manufactured Masonry l �i� >:::•::f;::: Infiltration control option is: ❑Full sealing
Treated Wood Sewer of joints. Blower door test. Exterior
air infiltration barrier.
:ST ES?z g Other Unfinished Basement� Sq. ft s>::>::>::>::.;;;:::::.:;.;::.:.;:.:::::::::.::;..•; .;.;<.::.:<:<z: 1 -Stor �.t tic >::::<'I :H. ..'I COSS:> ;:r 1;
Y s< :'<z Permi
Living Area No. Envelope Area �v0 5 ft. y
Seasonal pe BTU /HR
:if A gR: zs >3 Infiltra t)
T4 Other Permanent v" I 8 BTU /HR
Garage Sq. ft. Munici aI Utility P
Other .4$00 0•;•;!ost.:::
tigiPlus Basement Private On -Site Well L} I 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, e ress .r plied, o e I part t or municipality; and certifies that all the above information is a urate.
g APPLICANT'S SIGNATUR r DATE SIGNED
APPROVAL CONDITIONS This rmi issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalty.
A/Sr. L E ost (VI EASOR_ /4 He. ..2/.. /25
�4 iizNwsrc Copy of 772uss Th /CS (SW ri as/sc .41 77 F a*
FAA ,/u WeCciotX
Town Village Cit Count S of: Municipality Number
Y Y p y of Dwelling Location:
JUR I.N D DS 7-0 a6 6
�p.
a:..::::::.:: :::>:;::x>::::::;::.::.>:::.::
.t •.:.H3
>:s
Plan Review J!0 Vnstruction t
Inspection HVAC 3 a 4
Wis. Permit Seal 30 Electrical y 1 q(-1 Other Plumbing Date
1 >(J grosion L q J J
Total v I'I q
Cert.No.
SBD -5823 (R. 06/94) WHITE Issuing Jurisdiction YELLOW DILHR GREEN Inspector PINK Owner /Agent
Lei
�l QZ Clz
ZONING /LAND USE COMPLIANCE CHECKLIST
WI l
JOB LOCATION: u 3Y W(0> t TA"/ E. ZONING
PROPERTY OWNER/CONTRACTOR: I L) CC) IJ Ccz
CONSTRUCTION DATA: New Construction Addition Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.) e
COMPLIANCE CHECKLIST eA0ACo
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) Requir -d
REVIEWED BY: DATE: �/f
l
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address 3 l t.� tit 1J ����Ak
Owners Name (v (LTON �C� l 94A118a CREEK
Name of Subdivision
Lot 3a Bldg. Permit
No. of Units l
Fee Required At
Fee Paid LO
Owner's signature ice. Date
Inspector's signature �M 4 Date
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
GATE g/3/9T
NAME A4/ LTt AI 3 hSC..H ADDRESS
LOT 3a BLOCK '.1
5 UBD1V.�j ff� 1 1 C1Z��K ZONE
STREET NO. T WI IUDI,COIC IA?, LOT D I MENS I GNS
SIDEWALK EXISTING YES 0 NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 7 ,I9
FEE; $15.00
24
DEPARTMENT OF P U B L I C 'WCRKS
1, the undersigned, owner or agent of the above described property agree To have the
grade estaniished before excavation has commenced.
Hwy A /,ear
i zflY'
PRIVATE
WISCONSIN
_ = 10 ULITY EASEM
• SCALE. 1 - .3 O
= BUI SETB ACKS
( 2 5 " FRONT AND REAR)
( 7.5' SIDE)
SITE PLAN LOT 32
SAWYER CREEK SUBDIVISION
CITY OF OSHKOSH, WINNEBAGO COUNTY,
LAKE � z
6
•
LOT 32
W 4*
,>'
.�
� - ,
Al
7S6 pi
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PROP. TOP OF FOUNDATION WALL = 767.
BE
TOP RING OF HYDRANT 100' NW OF SW LOT CORNER 769.40
TOP RI OF HYDRANT 1 O'± EAST OF SW LOT CORNER 767.
�J"
OTS•
1. LATERAL L.00ATF OSHKOSH
S WERE OBTAINED FROM CI OF
AS
�BU1L. RECORDS. A TUAL L TA
LATERALS SHALL, BE FIELD VARIFIED.
2 . THIS SCHEMATIC ASSUM THAT ALL OVERH
EAVES, AND BUILDING PROJEC11ONS ARE LESS TH
FEET FROM THE BUILDING FACE. ADJUSTMENTS MUST BE
MADE IF ANY SUCH PROJECTIONS EXIST MORE THAN TWO
FEET FROM THE BUILDING FACE.
3 . BUILDING SIZE AND LOCATION TO BE FIELD LOCATED
AND VRIFIED BY THE O WN ER AND THE CITY P RIO R TO, AN D
DURING CONSTRUCTION.
4 . GRADING AND DRAINAGE OF THE LOT SMALL CONFORM TO THE
APPROVED GRADING AND DRAINAGE PLAN FROM THE CITY OF OSHKOSH,
DEPARTMENT T OF PUBLIC WORKS.
S.
5 . EROSION CONTROL SHALL BE INSTALLED AND MAINTAINED AT ALL
LOCATIONS WHERE NECESSARY TO PREVENT THE DEPOSITION OF
S ILT IN ANY SURFACE WATERS AND TO PREVENT ER OSI O OF
DRAINAGE SWALES AND DITCHES, ACCEPTABLE METHODS INCLUDE,
BUT ARE NOT LIMITED TO, ST SALES AND/ FILTER FABRIC
BARRIERS. EROSION CONTROL SHALL CONFOR M TO CHAPTERS
ILHR 20 AND ILHR 21 OF THE VSCONSIN ADMINISTRATIVE CODE.
#/"�� I IAT i
OAS SO C = S. B LU MO DR.
PHOW �414� 730-7014
1 ATE S FAX 414 739--775*
AUG. 1 1994