HomeMy WebLinkAboutBuilding /CITY OF OSHKOSH N2 07316
PERMIT - APPLICATION AND RECORD
TYPE: BLDGTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING Z 1 FLOOD PLAIN HEIGHTo'vg
ADDRESS / C 61 4: 7 72 e r- e4A- r` C( l `4Q PLAN NO. 6-/- " A" - O
OWNER t - t . � -c ( r f/`,..3
DESIGNER
USE /NATURE OF WORK / 0.4-- li ['k
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BUILDING CONTRACTOR 000 �y ` � Siz Sq. Ft. /1-47. S # Rooms T r 3 ing# Stories Height .J
Foundation fred Class of Const. g ` Occupancy Permitia
HEATING CONTRACTOR 1 Q e g-. ir‘ et a C`e
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR 7 )ca [c
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR b k_ kJ. K 'T o P.i
BT WH Disp °'� WSoft CBasin
Lav _ Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
G /
FEES: Valuation $ ge e / P- Fee Paid $ f ✓
��/ i/II/ yrJ 8'-'."- p /
Park Dedication $ � � 0
ISSUED BY 10 I / ,i .'ti _ Date 3 - o Final /O.P. -/` -eU
In the performance /
p ace of this work I agree to •-dorm all work pursuant to rules governing the described construction.
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SIGNATURE 7/,- -8 eg
/ AGENT /OWNER DATE
ADDRESS______ l OCO5.4.W 4¢ 2.35 `5 /Q
TELEPHONE #
State of<<Nisconsin
Department of Industry, WISCONSIN UNIFORM r /'„
Labor & Human Relations APPLICATION NO. "'f'
Division of Safety & Buildings BUILDING PERMIT
Box 7969 APPLICATION
Madison, WI 53707
Wisconsin Statutes 101.63, 101.73 (See Instruction on back)
PARCEL NO.
,. o r
i RUCTURE ❑HVAC ❑ELEC ❑PLUMBING
Owner's Name Mailing ress Telephone
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c,,. i ii !. . .. lQ u S C4t- Z. 3s - -S_ / o
Contractor's Nam Mailing Address Telephone
-P1a L rc BLS . ,lc[ Coo ,2T t - (4 14) e3s s 6t 0
% %, SECTION T N R, E(or)W
Building Address division Name Lot t
1(os ° � (1VEfm (LC. l V ER vtLL S t)1 VISI W Block No.
Zoning Dist% 1 Lot Area Front Rear Left Right
g (f S Sq. ft. Se / Setbacks 3 5 ft. & S --- ft. ' ft. i C ft.
ew ❑Addition ❑Raze 1► ' gle Family Entrance Panel ► T orced Air Furnace Fuel S•ace Ht •. Water Ht..
❑Alteration ❑Repair ❑Move ❑Two Family Size: CZ %.. amp • Radiant Baseboard or Panel LP Gas ❑ ❑
❑Other ❑Other Ser ice: ❑ Heat Pump Nat. Gas c
17: nderground ❑ Boiler
Fuel Electric ❑ ❑
❑Overhead
❑Central Air Conditioning Electric ❑ ❑
j ❑Other Wood ❑ ❑
K ttached ❑Detached 1 ite constructed 11 oncrete 11V,Pti, , i d i e Solar ❑ ❑
❑ anufactured ❑ .sonry e er Coal ❑ ❑
;- . r- i. Other
�,° ' l ;T . ❑Treated Wood � nicipal
Basements �`� Sq. ft. "'n ❑Other ❑Septic _ ec �
Permit No.
Z �G ❑ -Story a ';p Envelope ��� BTU /HR
Living Area °'F Sq. ft. -Story ❑Seasonal e` ,, Infiltration .. • BTU /HR
❑Other
Garage !r ermanent
9 484 Sq. ft. ❑Private -on -site Well :` A f s ;A
❑Other : nicipal Utility $ '. Oo0
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The applicant agrees to comply with the Wis . sin niform Dwelling Code and other Muncipal Ordinances and with the conditions of this permit; understands
that the issuance of the permit creates no .. ii..; ty, ex• -ss or implied, on the Department or Municipality; and certifie that all the above information is
accurate.
SIGNATURE OF APPLICANT " *e4 C l AT
CONDITIONS OF APPROVAL This permit is issued pursuant to the following conditions. Failure to co ply may result in suspension or revoca-
tion of this permit or other penalt . _
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ZIr •7 F-1 - ('loo A • ...•
1 , ` i i i i . � i , is ❑TOWN ❑ IL AGE �,�. TY ❑COUNTY Municipality Number Municipality Number of Dwelling
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❑STAY_ ❑ CEPEND: Location, if different —
l it^skat OF: t �A • t • •7 _ ���
FEES:
�� ��
— r� EMIT IEDB`1°
Plan Review'. nj�_ ❑Construction ���
Inspection v $ ❑HVAC NAME DTI K LD9c
❑Electrical
Wis. Permit Seal(s) ... $o ❑Plumbing DATE " C
Other $ ❑Other ,c
TOTAL $ 7Q 6 07 �J O CERT. NO. � •/ V
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DI LHR -SBD 5823 (R. 11/84) WHITE — Issuing Jurisdiction YELLOW — DILHR GREEN — Inspector PINK — Owner /Agent
ZONING/LAND USE COMPLIANCE CHECKLIST
IST
I. GENERAL
Building Permit # Zoning " / Conforming Non-Conforming
Job Location `b ((f t t Lc 4-d) Lot Dimension
Property Cwt s Ek4\ J Q U((O s tot Area .
- II. • CCNSSTR TICK DATA -
Describe brk: / `; sct,, 400 sti 4r-Ac p cs ACA
NEW CCNSTR<JC'I'ION ADDITION- -ALTERATION
Accessory Pool. Sitig1 Family-
Fence _ Deck/Patio Ztaa- Family.
Boathouse • • Sign _ Mild Family
Utility Structure _ Porch
Or (specify) _ Maaufacturing
III. OO LIANCE CHECKS
COmolies � Deficiency /Counts
JZ _ Use
Lot Width
Lot Area
_ Floodplain
Front Yard
Rear Yard
_ Side Yard (R)
— Side Yard (L)
✓ _ Parking
Building ding Area
L / /074 _ Lot Area per Family •
Corner Lot
-- Other (specify) 4E ��
IV. REVIEW AM OR=
The Planning Director, or appropriate designee, rust 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 propose&
Instances where work applies with the above criteria, the: pciaat gam 3b reviewed
by the Building Inspector without referral to the Planning Director':
L APPROVE) NOT APPROVE)
Plan Ca:mission Action Required
Variance(s) Required
REVIESvED BY - DATE ( 1/�// !Off
City Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address [ t -- e , C -
Own ers Name z c 1 l s w... t.e
Name of Subdivision 12-c`J L°-rInn.,c 11
Lot e t Bldg. Permit #
No. of Units (
Fee Required l Oro
Fee Paid (CO
� a =� Dat - Owner s signature irr /l -�
Inspector's signature dr° 1l u !FM/11! Date
Parks Subdivision
Improvement
Accts. Rec.: 362 -041
DATE ineaeciq a, /9h
NAME E/4 00.5 Ap e. 0 K1Z-5 ADDRESS 9 / 9 0-T "\--1'7'
LOT q BLOCK ' -. WARD /
SUED I V . f (/ /_L SJ8D1(/(sI o,J ZONE
STREET NO. 1' 1' ki V'-f l/ LOT 01 MENS IONS
SIOEWALK EXISTING YES 0 WA NO tra
BUILDING GRADE ELEVATIONS STAKES SET AT SITE , 19 se BY g-r
FEE: $10.00 iS,Z'��lc.■ ,.
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0 DEPARTMENT OF PUBLIC 'WORKS
1, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
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OSHKOSH, W1 54901
414- 235.5610