HomeMy WebLinkAboutBuilding CITY OF OSHKOSH N2 00060
`' PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN �d HEIGHT "/
ADDRESS / O i Z / V f f L 1 A PLAN NO47 - "' 4 4? ` 686 to
OWNER . ' T , E' 5 L.. /7 fc . - et- 4 --- 1 3
DESIGNER
Pao
USE /NATURE OF WORK > - 6 : 44 / L ' . I � & e. -40 " • IP
� A-!g L ( `
, d f Za4 36) , / 7( L /z, 4 Y
BUILDING CONTRACTOR■2
e (- S Ft. /
Siz
q• ��� # # Stories �` Height
Foundation OCR C'�/� �
� - � `��
�1 Class of Const. r Occupancy Permit � � A
HEATING CONTRACTOR 00 Ic4 0A
Heat R ❑ A/C ❑ Vent ❑ Fuel /System ae 7,4" Heat Loss BTU'S
ELECTRIC CONTRACTOR C}.,Adt / /
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR P4
BT WH Disp WSoft CBasin
Lav _ Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink _ LTub Eject SS Water
Other
FEES: Valuatio $ 4 ' 0 0 Permit Fee Paid $ V a d
Park Dedication $
ISSUED Date __Cr__1 — Final /O.P.
In the performance of this wor. - • ee to perform all work pursuant to rules governing the described construction.
SIGNATURE <IS ) O 1- ft
kli AGENT /OWNER DATE
ADDRESS
TELEPHONE #
} ZONING/LAND USE COMPLIANCE SST
I. GENERAL
n
Building Permit # Zoning Q v 0 Conforming Non- Conforming
Job Location / .,l "'LW/ �/ I It Dimension
Property Owner Q - F Lot Area
II. CCNSTRUC.TION DATA .
Describe Work: /(J 4',(,J C 6 SA ?"TA-GL(,f
NEW CCNSTRUCTICN ADDITION ALTERATION
Accessory Building _ Pool '>4ingle Family
—
Fence _ Deck/Patio _ 'No-Family
-- Boathouse _ Sign Multi - Family
Utility Stricture Porch Commercial
Other ( specify) _ Manufacturing
III. COMPLIANCE CHECKS
Complies Deficient Deficiency /Conents
Use
It Width
Lot Area
FloodplaIn
_� Front Yard
Rear Yard
Side Yard (R)
Side Yard (L)
Parking
Building Area
_ Lot Area per Family
Corner Lot
Other (specify)
IV. REVIEW ALTIHORITY
The Planning Director, or appropriate designee, must approve all plans, except
the following: (1) Alterations or interior work when the use is conforming and
when no change of use is proposed. (2) Maintenance items, e.g., siding, windows,
etc., when the use is conforming and when no change of use is proposed.
Instances where work oo plies with the above criteria, the permit can be reviewed
by the Building Inspector without referral to the Planning Director.
L — APPROVED NOT APPROVED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: ' A 6-
/i' DATE.:
State of Wisconsin
Department of Industry, WISCONSIN UNIFORM a 7 40 0
Labor & Human Relations APPLICATION NO.
Division of Safety & Buildings BUILDING PERMIT
Box 7969
Madison, WI 53707 APPLICATION �-q J - (o
Wisconsin Statutes 101.63, 101.73 (See Instruction on back)
PARCEL NO.
it n ',. A S
„: �, TRUCTURE I�HVAC �' LEC ❑PLUMBING
O �n - 's Name Mailing Address Telephone
7 -E QP L _ 710 3 de- -- 7
Contractor's Name Mailing Address Telephone
y
, lk, , �. 1 4 '/a, SECTION , T N, R, E(or)W
Building Address Subdi sion Name Lot No. Block No.
(zZ Vf�€- � � i4o.• / I� it /L (— cU d.,4) 4--
oning District Lo • rea Front Rear /1�/f� Left Right
l /� /. sq. ft. Setbacks ...
0 ft. L " ft. /4)- ft. ft.
1 1 2.
i e ❑Addition �Y ..ingle Family Entrant - `.� I: orced Air ‘4';'4"?.-- F urnac e F ue l s• ace Ht.. Water Ht..
VA Alteration ❑Repair •Two Family Size: / I amp • Radiant Baseboard or Panel LP Gas ❑ ❑
II: ar ge ❑Raze ❑Other Servi e: ❑ Heat Pump Nat. Gas A
ttached ❑Move W.' nderground El Boiler Fuel Oil 0 Detached ❑Foundation ■Overhead ❑Central Air Conditioning Electric ❑ ❑
❑ aster plan no. ' -a - ❑Other
(If applicable) Wood ❑ ❑ • :rte constructed ❑Concrete if � ` Solar ❑ ❑
V Manufactured ❑Masonry Sewer - - , - _- Coal ❑ ❑
❑Treated Wood : unic ipal Other
/ � ❑Other (Septic ,° , -- -
y Y
Basements Sq. ft. r.. °'_ P ermit No.
� I'i
// 01 -Story -� t , �L� B
Living Area �I,tO Sq - ft. -Story , - Infiltration �� BTU /HR TU /HR
I
❑Seasona j
Other L'.. _ °
Garage �- Permanent =R
9 �� Sq. ft. Private on -s W
■Other unicipal Utility O
$ OD d
The applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Muncipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no legal liability, express or implied, on the Department or Municipality; and certifies that all the above information is
accurate. /
SIGNATURE OF APPLICANT DATE (o i
CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or revoca-
tion of this permit or other penalty.
❑VIL LAG E . ITY ❑TOWN ❑COUNTY DSTATE
-
NAME /Ill' 4.L� MUNIC. NO.
FEES: PE � IT 1;y IC3 ` PERMIT 1;'x$0 BY
eD SEAL. NO.
4111 ill/ Plan Review $ ►� • nstruction
��
►'. VAC NAME
[..4..•
I nspection $ r. lectrical r 61
Wis. Permit Sealls) ... $ �� ■Plumbing DATE (A `� `i/
Other $ ❑Other 1E3?
/ 3 �T ,�ij
TOTAL. $ `. J ¢ CERT. NO. [i
DILHR - SBD 5823 (R - 1/82) WHITE — Issuing Jurisdiction YELLOW — DILHR GREEN — Inspector PINK — Owner/Agent
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28 GA H O U (D ET.
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LOT 4
City of Oshkosh 1 /1 /85
PARKLAND DEDIC TION FEE COLLECTION RECORD
Address A;;?-2,—
Owner's Name A:>,�T" / (ET/L__
Name of Subdivision . /� Lam_ SU,.64
Lot # 4 Bldg. Permit # C)
No. of Units
Fee Required /
Fee Paid ,--z9
i O
°\ C(.3.\°
wner's signature Date Inspector's signatures r da1W; Date — y
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
// DATE �--/3 -8 NAME V (Z- r /46 etocEP-- ADDRESS / 7/ IuUT C* ,
LOT 4 BLOCK WARD
SUBDIV. L/L MlLL. mac-'& ZONE (_— 1.4.
STREET NO. l - Ck j IW LOT DIMENSIONS
SIDEWALK EXISTING YES C NO1
BUILDING GRADE ELEVATIONS STAKES SET AT SITE S-- /4 ,I 9 8 6 BY �;/U
FEE: $10.00 c2)
,,, ::.c..." ------
e ‘ ,.."1:0 - 1::...e....ez - 0 .r
DEPARTMENT OF PUBLIC WORKS
1, the undersigned, owner or agent of the above describe • oper -.ree to have the
grade established before excavation has commenced.
i3e/ C V.53