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ONE- & TWO - FAMILY DWELLING Permit No.44
PERMIT TO START CONSTRUCTION
FEE $2 7.00IN ADDITION TO PLAN EXAMINATION /INSPECTION FEES
OWNER {STREET & N0.
CITY /TOW ' / 4 STATE & ZIP TELEPHONE
�,
r
DWELLING LOCATION STREET &
CITY /TOWN As, COUNTY
ACEN.4 (BUILDER, AACH. OR ENGR.) STREET & NO,
F`JD/ l(J /� LirJ ZS 5 Oa �� D rL.
CITY STATE & ZIP TELEPHONE
� ie-o5 74- = ?AS
I, the undersigned, request to begin footing and foundation work prior
to the approval of the plans and issuance of the UNIFORM BUILDING PERMIT
per Ind 20.09(5)(b)2.
I have reviewed the specific code requirements of the Wisconsin Uniform
Dwelling Code, Chapters Ind 20, Ind 21, Ind 22, Ind 23, Ind 24 and
Ind 25, as applicable and have shown compliance on the drawings.
I agree to make any changes required .after the plans have been reviewed
and to remove or replace all noncode complying parts of the footing
and /or foundations.
I agree to proceed with the footing and foundations only and will not
continue with the remainder of the dwelling until approval and a
BUILDING PERMIT has been issued.
I also understand that prior to the start of any construction, a zoning
permit and a domestic septic permit has been obtained from the local
authorities having jurisdiction in accordance with their laws and .
ordinances.
NOTE: Complete building plans are `,
needed for issuance of this permit.
4 114L-111
/AGENT SIGNATURE
Footing and foundation plans submitted
prior to final plans will not be
accepted for issuance of this permit. DATE
UNIFORM BUILDING PERMIT APPLICATION NO.:
ZONING PERMIT NO.: SEPTIC PERMIT NO.:
AUTHORITY HAVING JURISDICTION:
OFFICIAL TITLE
ISSUE ATE - FEE RECEIVE DATE
NOT ISSUED BECAUSE:
•
SW) - An7 (v S (e..\
ZONING/LAND USE COMPLIANCE CHECKLIST
KLIST
I. GENERAL
Building Permit # Zoning. I=1 onforming Non- Conforming
c
Job Location ?j cz)PekEwoo Q Dz Lot Dimension
Property Owner/01. G J= . 1 / Aj e- Lot Area
II. CCNSTRUCTICN DATA
Describe Work: PG- Go - i r A A rri Q ( t -4
/4ps
j,, C1C[+IS'iRU(.7.`ION ADDITION ALTERATION
Accessory Building — Poolingle Family
— Fence _ Deck/Patio — Two-Family
Boathouse — Sign — Multi - Family
— Utility Structure — Porch — Commercial
Other (specify) — Manufacturing
III. COMPLIANCE CHECKS
Camp Deficient Deficiency /Cments
Use
Lot Width
7/ Lot Area
1/7 Floodplain
—
Front Yard
14 — Rear Yard
Side Yard (R)
— Side Yard (L)
...1 -___ Parking
Building Area
V
_ Ipt Area per Family —
• ....1.42 Corner Lot
-rte — er ( i ) -
IV. REVIEW AUTHORITY
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 complies with the above criteria, the permit can be reviewed
by the Building Inspector without referral to the Planning Director.
APPROVED NOT APPROVE
Plan Commission Action Required
Variance (s) Required C ' tK 4 REVIEWED BY: DATE : 241---1=r
DATE /1 `S — 8q-
- NAME EC, 0 J ADDRESS , mi l / { �, r; .
LOT / /(,, BLOCK WARD /S
L� *£ -{ � �'k
SUBD ZON
STREET NO. 2 5 2 5 5 go 426 woo f) DR. LOT DIMENSIONS
SI DEWALK EXIST YES C NO
BUILDING GRADE ELEVATIONS STAKES SET AT SITE II" I ,19?),4 BY O's
FEE: $2.00
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.
• J zI
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