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CITY OF OSHKOSH N° 36351
PERMIT - APPLICATION AND RECORD
TYPE: BLDG j HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / 7 % Se 3/ h E14 PLAN NO.
OWNER ED AV 0
DESIGNER NIA
USE /NATURE OF WORK , ! t7 / X J o SEAS C /L(� AAJ4L
5x 16 a €K,
BUILDING CONTRACTOR .EN5EE // CT.
Size 16 ;16 Sq. Ft. 25 # Rooms # Stories / Height
Foundation Z Class of Const. 8 Occupancy Permit yL�
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change p 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
V
FEES: Valuation Permit Fee Paid $ ! 2 Park Dedication $
ISSUED BY -PM Date i q3 Final/O.P.
al /O. P.
In the performance of this work I agre perform all work pursuant to rules governing the described construction.
NATURE
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'w AGENT/ NER DATE
p 4j2pREss «7 / (/ /i P4. 3S ,5`0 20
TELEPHONE #
Revised: ?/ 9
// ZONING /LANG USE COMPLIANCE CHECKLIST
JOB LOCATION: / 7L/ Sl Oat) ZONING:
PROPERTY OWNER /CONTRACTOR: ED AaDE'Se7 J OEMS /1{6,
CONSTRUCTION DATA: ANEW CONSTRUCM ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCT (i.e. fence, pool, sign, deck, etc.)
16 x16 say 4(ub 5 p( Mi
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES OEFICIENT DEFICIENCY /COMMENTS
_ Use
_ Lot Width
_ Lot Area
Floodplain
Front Yard
_ Side Street (r Tt 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
REVIEW AUTHORITY:
The Director of Community Development, or designee, must approve 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.
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 Ac.. on Required
Variance(s) Require
REVIEUED BY: ' �' - DATE: /069//
I. OWNER_
ADDRESS � l/ �
DATE PERMIT # USE
5r'l , '-i, `y - _ Work consists of
GENERAL CONTRACTOR
/t /K / 6 / _� IV..!:.r0 . -z;0
MASON CONTRACTOR - ZONE
Width of lot
D_ INSPECTIONS
REMARKS
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Front of lot MAILING ADDRESS
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BEE N IA CIE iN PREPARM IHESE
PLANS AND CHECKIN(31 T�4cPvlf FOR'
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