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DO ° c° `� as a W oo ¢ Al V LL o O J m O a> L O a) 3 H QO w v i i Q ' m Z _ _1 1- Z Q = Y 0 m W ¢ Z c m 3 Z (� m ?_ c LL v v _ rn = d o cA m.0 ca = Y a) m rn 0 as 'E m V a) o co „ m mo 0 mmU c m L c Z O 0 > +.. �� C� O a) F- L a) a 1— c., . c- `� a) E 0 J H IU w wo i i ¢ w State of Wisconsin Department of Industry, WISCONSIN UNIFORM Labor & Human Relations APPLICATION NO. BUILDING PERMIT Z Division of Safety & Buildings Box 7969 APPLICATION Madison, WI 53707 Wisconsin Statutes 101.63, 101.73 (See Instruction on back) PARCEL NO. r ›STRUCTURE X-IVAC L EC ❑PLUMBING Owner's Nae Mailing Address Telephone m r( NV'. ko cr. 9.- was o 02 ' rnesc. (Ittt 3 I- a 2 3 Contractor's Name palling Address � Telephone 7 Uo, $ Q. / a . c_J SrMOctt._ 1�OAC. C i) SI 3 1-8a0 3 % Ye, SECTION , T N, R, E(or)W Building Address . Nam- Lot No. Block No. 48O l /J E zJwA S V SC irk '' R (I AST RAT 54 — Zoni D istrict Lot Area Front Rear Left / Right / (L 7 o � O Sq. ft. Setbacks ft. ft. -7 ' 2 - ft 10 t / ft. ' 9f° '' t:- ' tea . .. . i ew ❑Addition I1 - ingle Family E ntrance Panel ►! orced Air Furnace Fuel Space Htg. Water Htg. ❑Alteration ❑Repair ❑Two Family Size: 100 amp ❑ Radiant Baseboard or Panel LP Gas ❑ ❑Garage ❑Raze ❑Other Ser ice: ❑Heat Pump Nat. Gas ❑Attached ❑Move 7. nderground ❑Boiler Fuel Oil ❑ ❑ ❑Detached ❑Foundation ❑Overhead ❑Central Air Conditioning Electric ❑ ❑ ❑Master plan no. *t; x ❑Other Wood ❑ ❑ �� ' (If applicable) ❑Site constructed oncrete " ' . ' '' '. Solar ❑ ❑ , anufactured ❑Masonry Sewer Coal ❑ ❑ L7 .4. ❑Treated Wood rrfc unicipal Other i ©0 a 54 oRtEs ; ❑Ot her ❑Septic �. .. Itr., I ll hated)" Basements Sq. ft. Permit No. r = -Story Envelope - �r�3► BTU /HR Living Area ` C3 c:38 Sq. ft. 02 -Story - Infiltration . Iffy BTU /HR DOther ❑ easo 11• tV ,, . w • Garage ,------- Sq. ft. ■ •e an nt ❑private -on -site Well . ° „f Up Asti ❑',ther Municipal Utility The applicant agrees to comply with the Wisco• in Uni ' swe • ode and her Muncipal Ordinances and with the conditions •f this permit; understands that the issuance of the permit creates no le•<1 liabi • -xpres i . i• • • - the Department or Municipality; and certifies that .II the above ' formation is accurate. ry SIGNATURE OF APPLICAN /� •— i� DATE 41 4 MN mow 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. QO • t- s' - 0I C. 1,3 11 5t . - 'a. &SSt -1V, • A cn K . ks IIIWIN T iTletr te r _ . T3` • ■ �.� j� tAJI LL-t /.) 1-s' IA! PEA FP-0m 'T 4t . NWPAC/vitt/4 ' - I.Z. r f . +i, a P. .. ► 0. • • S 4 y C.L. 0 << / ► �i .. l.� r . Z+ ±� 47.1, 4 4 ❑V IL LAG E ›■ITY ❑TOWN ❑COUNTY ❑STATE %.i .- Y';' NAME �� MUNIC.NO. 2 b 6 FEES: t f, '' €h : -' , 5 , ;, s a - If • nstruction Plan Review $_. VAC / NAME two C_� �- M Inspection $ f : Iectrical Wis. Permit Seal Is) ... $ � 0 1 ThL rg DATE c!3—q-84 Other i et er geV O /' Cn TOTAL $ `�-� CERT. NO. n`t DILHRSBD 5823 (R 71/82) WHITE - Issuing Jurisdiction YELLOW - DILHR GREEN - Inspector PINK - Owner /Agent ZONING/LAND USE COMPLIANCE C HECK LIST I. GENERAL • Building Permit # Zo ' /Conforming Non-Conforming ?c Job Location isti • YL Lot Dimension la.) Property Lot Area72d0 C II. C TSTRUCTIM DA3 f • Describe 14ork; NEW CCISTRUCTIC T ADDITICN AL3ERATION Accessory Building Pooh Single Family Fence Deck/Patio Two - Family Boathouse Sign Multi- Family Utility Structure Porch Catanercial Other (specify) Manufacturing III. ©DMPLLANCE Q1S c lies Deficient Deficiency/Caments Use Lot Width Lot Area Flobdplmin Front Yard Rear Yard Side Yard (R) V Side Yard (L) Parking 2/ Building Area Lot Area per Family `� C7 Corner it Other (specify) — IV. REVIEW AUTHORITY The Planning Director, or appropriate designee, must approve all plans, except the fo7.lcwing (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 ix) change of use is proposed. Instances where work caipLies with the above criteria, the permit can be reviewed by the Building Inspector without referral to the Planning Director. Cf APPROVID NOT APPROVED Plan Cannission Actio •r • • - Variance(s) Required ,‘‹A dit}kt- DATE: P DATE f-- 2 -‘= )-- 2f 4 NAME AN-MA e ADDRESS l - ?Cow Ct 55 - )e)g -" c LOT 54- BLOCK ?BARD 1 SUBDIV. 51 - - / ONE , —/. STREET NO. 0 . LOT DIMENSIONS I MENS I O C NS g C4-7‘1J-6 r--- SIDEWALK EXISTING YES NO Fl BUILDING GRADE ELEVATI NS STAKES SET AT SITE 8 ,1984 .BY FEE: $2.00 0: / DEPARTMENT OF PUBLIC WORKS 1, the undersigned, owner or agent of the above described %roperty agree to have the grade established before excavation has commenced. i At..,, i1 . Ai 3186 35/5 • i J • �� N 1 • w .• w 00 u r I NA' N I Q • n1 g ` `1 -9 „,p, 7i a, C ry • ” as h ni C 1 I g 1.n c x rn c� r� I-4 • g illfr i 9. o t � nnn r in ! s I Ah . # .rs t.r i •.17 ,7.1 • g W � .. • . Y • //y • W ' 1 00 W , .. _�� a o ~ o + 3 o o u o A s j I y Ha c y o � y o 0. 1> I t �> 1 • e O pp - w x N g P. t� 1 s o i Q I y ` � 1 � 1 i • i • - t + . 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