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CITY OF OSHKOSH No 13580
PERMIT — APPLICATION AND RECORD
TYPE: BLDGA ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING I FLOOD PLAIN HEIGHT" "'
ADDRESS._./ 1Z r" Kt r r r / / PLAN n � N 3 �f ' &L
OWNER pr-c4 94 Ir ritJ
DESIGNER
USE /NATURE OF WORK d i. Gt> At
BUILDING CONTRACTOR 0 Gc) Pte r
/ 0.om /_
Size�O Sq. Ft. ` / f "' ` Rooms CSi D a �4 # Stories Height
Foundation Class of Const. Occupancy Permit -� / ' •
HEATING CONTRACTOR '"'.."7:-- - pfr r
. Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR 2 /
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR 1:2N l`-r -q cm- L
- 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 $ a i�I . Per p' F Paid $ ...-
, -Va.' / P ark Dedication $ t",d
ISSUED BY ilk lir . _ e ..., i Date S - 3o r Final /O.P. ii ' / -S 9
r
In the performance of this work I agr- : to perform all work pursuant to rules governing the described construction.
c
SIGNATUR..__. ` ,gd if
AGENT /OWNER DATE 7
ADDRESS 3/32 W A ,.=z. a ILI --e f1 9 o G/.5
/ TELEPHONE M
/3 3 -- '- S - a? ,
State Department o fInd WISCONSIN UNIFORM
Department f Industry,
Labso afety 8 Buildings an Relations
Divisi on n of S BUILDING PERMIT APPLICATION NO. /"_ 8V
Box Madison, Mad n, WI 53707 APPLICATION
Wisconsin Statutes 101. 63, 101.73 See Instructions on back of pink copy) PARCEL NO.
PERMIT REOUESTEC : ❑ STRUCTURE I HVAC ❑ ELEC ❑ PLUMBING
is Name Mailing Addr ss Telephone
t3 L k--r -j 3 r 3z (44.A.K1 Ce.Vtk QT — 231— 4s kit
Contractor's Name Mailing Address Telephone
(2k,t Li JAS '3 ( 3 2 � N+c /c!2 J Z 3 i — ces if
IROJECT LOCATION
'' /a, ''/4, SECTION , T N, R E (or)W
Building Address S ivision Name Lot No. Block No.
E ILL. atkA ` 1 v � ILL —
*
Zonind N CO 0V District Lot Area Front 3s /f Rear Left 7l/ j� Right
1 /3 o cn CO sq. ft Setbacks SIg ft. C Z ft. 7 —n r ft. 2- ft.
#a isROJ
"
3 T 'PE 6 :ELECTRICAL. II I4VAC EQUIPME I i2F:< :ENERGY SOURCE
F ew ❑ Addition ❑ Raze Family Entrance Panel ,Forced Air Furnace Fuel Nat. L.P. Oil Elec. Solid Solar
❑ Alteration ❑ Repair ❑ Move ❑ Two family Size: o0 amp ❑ Radiant Baseboard or Panel Gas *
❑ Other Se vice: ❑ Heat Pump Space Htg• lir ❑ ❑ ❑ ❑ ❑
❑ Other Underground ❑ Boiler Water Htg. R ❑ ❑ ❑ ❑ ❑
❑ Overhead ❑ Central Air Conditioning
' b I�"aARAGE 4 YPE 7 FOI ii3ATJOoi => ❑ Other
more installed electric space heating equip.
e
he
LSite COnStruCted Concrete 'l(i :PLUMBIING Infiltration control option is: El F sealing
ached ❑Detached ❑ Mason of joints. ❑ Blower door test. ❑ Exterior
❑ Manufactured ry pew
2. AREA ❑ Treated Wood ....Municipal air infiltration barrier.
1 S61 �� ❑ Other ❑ Septic
Basements l r- Sq. ft. : S +ptEIIES" ti 73 ::::I AT LOSS: €Calculated}
Permit No
Sf ❑ 1-Story 8 USE Envelope O BTU /HR
Living Area Sq. ft. -Story ❑ Seasonal �1 . 111:fATER :' Infiltration / '1 44° c ' BTU /HR
Garage Sq. ft. ❑ Other Permanent , Jiunicipal Utility 9d :: ESTIMATED COST
/O--1— / ❑ Other ❑ Private on -site Well O61 Q
The applicant agrees to comply with the Wisconsin Uniform Dwelli g.Code and other Municipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no legal li lity, expres oyimplier�, on the Department or Municipality; and certifies that all the above information is
accurate. p /
SIGNATURE OF APPLICANT . f �.s i G 0 - 89 DATE
CONDITIONS OF APPROVAL This permit is iss d pursuant to the fol ing conditions. Failure to comply may result in suspension or
{j o,,� revocatir of this ermit or other penalty. i
p.¢ ij RA r r - V 1"1,--5 l cr (ti . S . P / 4a y"-• 4 15 P-- i ' Ci %` i-1 `O c l
ISSi ❑ TOWN ❑ VILLAGE CITY ❑ COUNTY Municipality Number of Municipality Number of Dwelling
❑ STATE INDEPFN Inspection Authority Location, if different
JURISDICTION OF: ,S o - V\ �D_ -
PER S W ill f�E�M PI °I MIT
S P IiiT tS iJ)itl)131C
SEAL
Plan Review s .`a. . $ Construction
HVAC
Inspection . . . . $ ❑ Electrical NAME `� Gt L }' tti r��p \ 4:: ( 1
Wis. Permit Seals) $ � ❑ Plumbing DATE � � -'T 7
Other $ -7 ❑Other 7 3 ? O .__ ,q j ¥
TOTAL . . . $ ! O CERT. NO. - ( ( ✓
SBD5823(R.04/87) WHITE — Issuing Jurisdiction YELLOW —DILHR GREEN — Inspector PINK— Owner /Agent
=ME/LAND USE COMPLIANCE E C HECK IST
I. GMEPAL
Building Permit t Zoning /2 , Comb=ing IbreConfozmia y
Jab Ic ration U'{lh/4/CL Lot Dimension
Pr:party Cr L (l �/ vs rat Area
11.
OINSTRECTIOS DATA
Describe /� <t.J Iu / 7' - �GLD ,C 4/
G�
NEW OINSTRUCZCOM
Accessory Buildirg _ Pool • — Sitigik Family
Fence Deck/Patio 'No-Family
•
—
Boathouse Sign — *ilti.- Family
— Utility Structure Porch Cke+ercial
Other (specify) Manufactsaing
=. crspwArizz macs
Deficient Deficiency/Comte
Use
lot Width —
lot Area
/ _ Flcodplain •
_✓
—
Front Yard
B ear r Yard
_ Side Yard (R)
Side Yard (L)
- Parking
Building Area
_ �pra�Family
•
OmmerIot
O ( )
IV. REVIEW AMOK=
The Planning Director, or appropriate designee, meat approve aLt plans, except
the following: (1) Alterations or interior work when the use is eon fo=ang and
when no change of use is proposed. (2) Maintenance items, a :g... siding, wiadow,a.
• etc., wizen the use is conforming and when r charge of vse is. proposed.
Instances where work ccuplies with the above criteria, the peat n. bia reviewed
by the Building Inspector without referral to the Planning Director.
= APPROVED NW APPROVED
Plan Cession Action Required
Variance (s)
REVIEWED BY: 22 D
6 4 1 t_ /4';
:ATE AA-1 Z 7 7fF
NAME { (2(i. QC i L( CJ ) ADDRESS 3 f 3 2 /1 -- A,UKviCf/ fic_ Cerw..,
LOT 1 BLOCK WARD /2
SUBDIV.P1 UF.(2}M(L( (.)1301VlStcl,, ZONE
STREET NO. `boo / t L by -(.. g17 LOT DIMENSIONS 4V, t 'k /3S-es Z /2edce,ucQJ—
SIDEWALK EXISTING YES NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE : /Z4 ,I9 89 BY '
FEE: /0'`'
DEPARTMENT PUBLIC WORKS
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
ii, 1
7 03998
•
City of Oshkoah 1/7/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address �16dp , \, r Y7
Owner's Name
Name of Subdivision 72pe1 < ' //
Lot # ( Bldg. Permit # /
No. of Units
Fee Required (00
Fee Paid /00
Owner's signature _ _ .10!;, gate
Inspector's signature eh, � / P' aite . � m
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
ZClVIDS/L ND USE COMPLIANCE =CRUST
I. GENERAL
Building Permit
Zoning Confoacting NosrCanfarminq
Job location/4 00 C IL r‘t.p Prr4A I 1/ Lot Dimension
Ply Caner r Lr' X ‘e Ct -S Lot Area
II. OCNSTRUCIIQI DE'A
Describe Work: r `I- _0
17�r1.g-
•
NEW CCNSTRO=CH anoCErIc i •• _ ALTSRATICN
._ Accessory _ Pool SUVA Family
Fence _ Dedc/Patio 210-Famiily
Boathouse Sign 14iLti- Family
Utility Structure Porch _ off.
Other (specify) _ Manufacturing
III.
Use / 4/..N.''` Y,
—
Lot Width.
— _
Lot Area " " /'" I
sl lain .
. Front Yard / /
S-.1 , -,/.,. 7
_. Rear Y ia . d H/. t... i...., takCs *to _ // _
_ JJ ���
Sills Yard , /J v•. /�•� ��J
_ • Parking fK .4. „ 1I y / .6i Bu ldirg Arsa .
_ _ lot Area per Family .e___-
• Corner lot
— _ Other (may)
IV. REVIEW AUTROZMY
The Planning Director, or appropriate designee, must approve all plans, =rept
the following: (1) Alterations or interior work when the use is confo=ing and
when no change of use is prom. (2)Maintenance items, e:g:.. adding. windows.
etc., when the use is confozmirg ard when no change of ie is propane&
Instances where work =plies with the above by the Building Inspect without referral to the criteria, be reviewed
Planning Der.
Plan Commission Action Required
Variance (s) Required
REviDED Br: DATE:
.
_ FRED P. LITJENS
Builder
L_ 4537 Honeysuckle J 07 - 07 - 1 72 J a. 2 lei.-,; lei.-,; L _-- /Z 0
�'1 OSHKOSH, WISCONSIN
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