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N9 38646
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
TYPE: BLDG(X HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 6 :o9 '► /'`' " - .c PLAN NO.
OWNER 710AJ `- Di4U' /S
DESIGNER USE /NATURE OF WORK (sn) Qoiocr VP( / - _ , J 7b77/4 '.
SWeD /N 244C-IC k J ,
BUILDING CONTRACTOR .0
Air
Size /2- o
Sq. Ft. 96 # Rooms # Stories / Height
AID
Foundation 7? t'4T WAD Rif Class of Const. Occupancy Permit /"
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent D Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR
- BT WH Disp WSoft CBasin
_Lay Sh DW DF San. Sewer
— WC FDr SP Ur Storm Sewer
- Sink LTub Eject SS Water
Other
cs
FEES: Valuation $ CO ` Q Permit Fee Paid $ /D• Park Dedication $ —
ISSUED BY Date 3 00 9 Final /O.P. IP/0 , /
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE -a :/A. ��/ / - ■ 3 z 07
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j 1 AGENT /OWNER 1 ; D ATE
ADDRESS 2- D 07 ! /1//4 / DPI-i0 5 / , 051--( j t.JJ 1 I / L. ; 3 3 3 z- c
TELEPHONE # •
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Revised: E/B'°
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: .3Di9 _ ; / '' 104/0 ZONING:
PROPERTY OWNER /CONTRACTOR: Ai 0 4 1/1,
CONSTRUCTION DATA: NEW CONSTRUCM ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
C7a c r 4 . 7o Q C g J CJ( y//
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
Use
• Lot Width
Lot Area
Floodplain
_ Front Yard
Side Street (frost yard)
Rear Yard
Side Yard (R)
Side Yard (L)
Parking Spaces
Building Area •
Lot Area Per Family
_ Corner Lot
_ Landscaping
_ Transitional Yard
_
Off-Street Loading
Vision Clearance
Height
REVI:A AUTHORITY:
The Director of Community Development, or designee, must approve all plans, except the
following: (1) Alterations or interior work when the use is conforming and when no change
in use is proposed. (2) Maintenance items, e.g. siding, windows, etc., when the use is
conforming and when no change is proposed.
Instances where work camp ies with the above criteria, the permit can be reviewed by the
Building Inspector with t referral to the Director of Community Development, or designee.
APPROVED DENIED
Plan Commission Action Required
Variance(s) Requir --
REVIEWED BY: /i O DATE: 2��/
00
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OWNER ...y0 .L 1/I S ADDRESS ;?OO7 s'ilteho o
DATE 3) as) 95 PERMIT #3g6y6 USE rrrie)
£ We xk consists of
GENERAL CONTRACTOR F' x ! 2 5 ba °e 3
MASON. CONTRACTOR ' ZONE
Width of lot_
DATE INSPECTIONS
REMARKS
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Front of lot MAILING ADDRESS