HomeMy WebLinkAbout0068004-Building CITY OF OSHKOSH No 0068004
4,
OSH OSH H BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 75 ROLLING GREEN CIR Owner FOX CITIES CONST Create Date 1/4/99
Designer FOX CITIES Contractor FOX CITIES CONST CORP 5/4/98
Category 110 - New Single Family Plan C5- 022 -297MP
Type 0 Building 0 Sign 0 Canopy 0 Fence 0 Raze
Zoning R -1 Class of Const: 8 Size 46' X 50'
Unfinished /Basement 1148 Sq. Ft. Rooms 5 Height 21 Ft. u Projection
Finished /Living 1148 Sq. Ft. Bedrooms 2 Stories Quad -leve Canopies
Garage 484 Sq. Ft. Baths 1 Signs
Foundation . Poured Concrete O Floating Slab O Pier O Other
0 Concrete Block O Post O Treated Wood
Occupancy Permit Required Flood Plain No Height Permit Not Required
Park Dedication Required # Dwelling Units 1 # Structures 1
Use /Nature NS}-R/ Unfinished lower level - NU DECK UR PA 110
of Work
HVAC Contractor MCM HEATING
Plumbing Contractor JIM'S PLUMBING
Electric Contractor SCHAFER ELECTRIC
Fees: Valuation " 5,000.00 Pla Approval $40.00 Permit Fee Paid $262.50 Park Dedication $100.00
Issued By: Date 1/4/99 Final /O.P.
U Permit Voided
In the perfo of this rk I agree to perform all work pursue t to rules governin t described construction.
Signature � �
n �° /! Date 7.--.(1g �
eai''ewner L
Address 1460 W SOUTH PARK AVE OSHKOSH WI 54901 - 0 Telephone Number 235 -8008 JOHN m -5
OSH'OSH
GRADE STAKE FORM
ON THE WATER Grade Stake Number 6090
Name FOX CITIES CONST Address 75 ROLLING GREEN CIR Create Date 01/04/99
Lot 41 Block Ward
Subdivision Rolling Green Meadows Zone
Street Number 75 Lot Dimensions Irrg Sidewalk Existing
Building Grade Elevation Stakes Set At Site 00 /00 /00 Set By
Department of Public Works
I, the undersigned, owner or agent of the above described property agree to have the grade established b: re excavation
has commenced. ( . /
(513-g _
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Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations
Safety and Buildings Division BUILDING PERMIT 0068004
P.O. Box 7969 APPLICATION Parcel No.
Madison, WI 53707
Wisconsin Statues 101.63, 101.73
•• ii ' •; ® Constr 0 HVAC 0 Elec 0 Plbg ® Erosion ❑ Other:
•wne s lame Mailing Address telephone No.
FOX CITIES CONST 1460 W SOUTH PARK AVE OSHKOSH WI 54901 - 0000
on ra or: Con ❑ Elec ❑ HVAC El Plbg Lic/Cert # Mailing Address e ep one ' o.
FOX CITI J I;VNJ 1 l VKl' 514 /ytS 1305 1460 W SOUTH PARK AVE OSHKOSH WI 54901 - 0000 235 -8008 JOHN
ontractor n Con ® Elect] HVAC ID Plbg Lic/Cert # Mamng Haaress I elepnone No.
SCHAFEK tLtl; I Kll. 6326 PAYNES PT NEENAH WI 54956 - 0000 725 -2031 585 -3
L ontractor D Con Ej Elec El -HVAC 0 Plbg Lic/Cert # Matnng 1 elepnone NO.
MCM HEA 1 iNu 6122 COUNTY ROAD M WINNECONNE WI 54986 - 9780 582 -4402
Lontractor: Con 0 Elec - FIVAC� Plbg Lic/Cert # Matumg Address i elepnone No.
JIM'S PLL� tsuNti ❑ W -6166 GREENVILLE DRIVE GREENVILLE WI 54942 - 0000 757 -5258 OR 75
�
.� �° ���� � _ �'=q` � '• : Sq. ft. 1/4, 1 /4,Section ,T N,R E(or)W
- ui • ing ' • . ress ubdivision Name Lot No. Block No.
75 ROLLING GREEN CIR Rolling Green Meadows 41
zoning Distnct(s) Zoning Permit No. Front Rear Lett Right
Setbacks ft ft. ft. ft
§:' a . y is ❖ :•i:• �i : ❖i :•i • ••i i ` ". �,. �•• •te � •
a. • i• � d a' t s - ' .i:❖i : ❖ :•i X' .+.' '' '1
s � �.�w � !.iiirw €'E"��.....>.;§' ii!!r � £ �"� . <<: ....� i � �v, t .... iiiiiiiiiiiiiiiiiii :.� :!:: :! :! :n! :.c
® New ❑ Repair I►14 Single Family ntrance 'ane Forced Air Furnace .•. Fuel 0 Alteration 0 Raze • Two Family Size: 200 am. • Radiant Baseboard or Panel
Addition Move Garage Service: • Heat Pump Space Htg Z 0 0 0 0 ❑
Other (print): • Overhead • Boiler Water Htg ® 0 0 0 0 0
Other ►� Underground Central Air Conditioning
Dwelling unit wil have 3 ki owatt or
l' ' • •� , '' •.•. Other
�:•� ' .o more installed electric space heating equip.
t , � £ � ': ••: o '• �
•••.. Z Site Constructed �� •. Concrete 36•=, 1^ •;;.;s.;;;;....;.;. .o;;.;, s••o•...•o •, p 9
O'•=- - -•• Infiltration control option is: 0 Full sealing
Unfinished 0 Manufactured • Masonary Sewer of joints. Blower door test. Exterior
Basement 1148 Sq. ft. ' ,,� . / Treated Wood j
Municipal
•` a s�v ....•.:•. • p air Intlltra IOn battler
■ Other
Septic •i t 8'h �� i., _: `'� OOi i•0'iiiii�
Living Area 1148 Sq. ft. 1-Story p .' � '' drv!•;ig�::i ;i ;i; e
2 -Story •R M•t•tifi -- Permit No. Envelope 1 . BTU /HR
Garage 484 Sq. ft. Other easona
vos ❖.-• •.•� Infiltration
19520
��j Permanent • .. ❖.• ❖.•. ❖..� BTU /HR
• Other Municipal U tilit ya '-
0 Plus Basement N Private On -Site Well $87,000.00
e app scan agrees to comp y wit a app Ica• e co•es, statues an• or•inances an. wi t e con •1 ions o t is permit, un• erstan • s t at e issuance o
the permit creates no legal liability, ex• - s or i••plird, on t• • ep "rtme tor' u icipality`a d certife that all the above inform cc
ation is aurate.
APPLICANT'S SIGNATUR t l J, /, 7_ / Ad , , ; ? DATE SIGNED J ' - 7 V ( —
APPROVAL CONDITIONS 1 his permit is Issued pursuant re following conditions. Fa ure to comply may result in suspension or
revocation of this permit or other penalty
...... .. .......
• � r • LJ Town Village El City County State of: Municipality Number of Dwelling Location:
°`• i' City Of Oshkosh 7 0 - 2 6 6
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Plan Review $40.00 Z Construction
Inspection HVAC Name Brian Noe
Wis. Permit Seal $30.00 Electrical Date 01/04/99
Other Plumbing
7 Erosion
Total $70.00 215042 Cert. No. 70266
SBD -5823 (R. 07/92)
OSH'OSH
(g) PARKLAND DEDICATION FEE COLLECTION RECORD
ON THE WATER
Job Address 75 ROLLING GREEN CIR Date 1/4/99
Name FOX CITIES CONST
Address 1460 W SOUTH PARK AVE OSHKOSH WI 54901
Subdivision Rolling Green Meadows Lot 41
Building Permit Number 0068004
Number of Dwelling Units 1 Number of Structures 1
Fee Required $100.00 Fee Paid
Owner's Signature 0 / i Date 1 ��
r / . , � . �
Inspector's Signature � Date p$
N 00°24'00" W 90.0i'
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LOT *41
12,455 SQUARE FEET
ROLLING GREEN SU5DIYISION = m
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