HomeMy WebLinkAbout0040836-Building o (
CITY OF OSHKOSH N' 40836
PERMIT - APPLICATION AND RECORD -
TYPE: BLDG
K HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS StS1 — - 1�,i PLAN NO.1 — � — � ?AV p
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OWNER 1 ,S(1\�. C-)+ - -' ‘' �C_\ L‘‘1��
DESIGNER ��"�'
USE /NATURE OF WORK s(1,::,._ v f t^v kl � , � f s,c,_
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BUILDING CONTRACTOR ( 1 ``-Y ? }
� 1.C) } > --
Size \ Sq. Ft. \ # Rooms `� # Stories / Height C)
Foundation rL �- c� Class of Const. - \ Occupancy Permit
HEATING CONTRACTOR t-
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR 1'
Electric Serv. New ❑ Change p 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
1/4_4 -�+�
FEES: Valuation '• - Permit Fee Paid $ .� .- I Park Dedication $ � A �
1
ISSUED BY Ni—t, 4 . 1 -,'�_ Dat �'?� 1 -`� Final /O.P.
In the performance of this work agree to perform all work pursuant to rules governing the described construction.
T 4A7 SIGNATURE g / q'
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
Lsji — 6ir€0
ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: voz. ZONING it (
PROPERTY OWNER/CONTRACTOR:
CONSTRUCTION DATA: New Construction Addition Alteration
TYPE OF CONSTRUCTION: (Le. fence, pool, parking lot, sign, etc.)
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COMPLIANCE CHECKLIST //-to
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DEFICIENT COMMENTS
Use
Lot Width
Lot Area
Lot Area Per Family
Floodplain
Front Yard
Front Yard Side Street
Rear Yard
Side Yards
Building Area
Parking Standards
Off - Street Loading Standards
Vision Clearance
Transitional Yard Standards
Landscape Standards
Height
Conditions of Approval / „1
Compliance with P.C. or -- ` G �
BZA Conditions of Approval
Signage Standards
Drainage Plan
REVIEW AUTHORITY
As per Section 30 -5 Enforcement of the City Zoning Ordinance, the Director of Community Development, or
designee, must approval 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.
{--- APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY. DATE: 7/70(
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4 0 ' .4„, 6
Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations BUILDING PERMIT L \
Safety and Buildings Division
P.O. Box 7969 APPLICATION Parcel No.
Madison, WI 53707
. Wisconsin Statutes 101.63, 101.73 (See instructions on back of pink copy)
PERMIT R E LE.STE
[��Constr ' < - �osion ❑Other:
ow s Name :.... _ Mailing Address Telephone No. (include area code)
x'760 Le...4,0_, , i 0 23/ sZe33 '
Contractor's Name Mailing Addre Telephone No. (include area code)
Lot Area
PRQE LA`I''l#I Sq. ft. 1/4, 1/4, Section T N, R E (or) W
B ` di ` n • Ad. ress / SubbdivvisionName {� Lot I Block No.
.614..ff 9.A.,-0"—J
Zoning District(s) Zoning Permit No. Fr ont Rear Left Right
Setbacks a5' ft. 5`7 r ....... ft. ....... 7 ' ' r ft. 7't 1 ' ft.
. O Cf' . ........... :.::::::. .:.. :.:...; ..; . .; � , : . ��E�t��. fit! �. Y L . �� ,. .E
�.EC'l�q >::;<: ::::'.�. .�::EQUIP��1�T >
1,:<.; :� �. Ek` �! �: �1:; 5 EEiCE.: ::: ;.:..
.;. .:.;.::
.;:..::
Iew ❑ Repair Single Family Entrance Panel [f o Air Furnace Fuel Nat. L. P- Oil Elec. Solid Solar
❑ Alteration ❑ Raze ❑ Two Family Size: /Ot amp ❑ Radiant Baseboard or Panel Gas
❑ Addition ❑ Move ❑ Garage Seryice: ❑ Heat Pump Space Htg 40 ❑ ❑ ❑ ❑
❑ Other (print): (Underground ❑ Boiler .
❑ Overhead ❑ Central Air Conditioning Water Htg ilzr ❑ ❑ ❑ ❑ ❑
❑ Other ❑Other * 0 Dwelling unit will have 3 kilowatt or
p. J ; !1 more installed electric space heating equip.
ite Constructed oncrete P g q P
_ '�� >PE3U�lI��� «`'' > >< » »> Infiltration control option i : Full sealing
CI Manufactured ❑ Masonry ............ P s ❑ u sea g
................... ...............................
of joints. ❑ Blower door test. ❑Exterior
❑Treated Wood Sew r air infiltration barrier.
:: T<; ?[ ><> Other unicipal
Unfinished Basement /Micq. ft. � . ❑ ;; z::<;::,,.::;:. ::,,.:;...:.:-;,,....::.:;:;:-: ,, , z;:;
N]" -Stor : >: ❑Septic �.N£;<tT.pT�S..tJa #.:
�� 4 S ft . Permit No. Envelope / t r d'* 3 BTU/HR
Living Area q- ❑ 2 -Story ❑ Seasonal
I
EGarage nfiltration 2 ❑ Other .. ��, BTU /HR Sq. ft. �rmanent ..: y I ili a Utility
❑Other Y 14 ;:� ��x,���s.�'S� .. :: ;
041us Basement ❑ Private On -Site Well is .e;YQao
The applicant agrees to comply with all applicable codes, statutes and ordinances and with the conditions of this permit; understands that the issuance of
the permit creates no legal liability, express or implied, on th a ent or municipality; and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE 4 77:4 DATE SIGNED 6/20/91/
APPROVAL CONDITIONS This permit is issued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of this permit or other penalty.
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/ is ( 77 ;4 rc- 13✓3.S r 7- Ar T /?.ge-nhfJ6
/ / - ) / )r7C) 77AEl
Town
Village 13 n
County ❑ St of: State o Municipality
9 ❑ N m r
u be f Dw Ilin
❑ o e L i
Y ocat n• o
': 7 - 0 - ,6 6
;: is :i:;: � .. .. :. ... ....: �:::;:.;:.;: a:-:: �::.:;::::•;: c::.::.:.:.::.:::::: c;:•::•;:.:::.::;;•;:::::: c:.:.:::.::.::• ::;•:r•::::::•s::.::n;:.:;;•;:: :: ::-,.
Plan Review $ (/ onstruction
Inspection $ G cAC Name Ai / :� ;:•;:•; >;;:;; :.;;:•; > /c/96); 7 Wis. Permit Seal $ ❑ Electrical ER 4 C `
Other $ ■ Plumbing
' .sion _
Total $ Cert. No. Air C V'
SBD -5823 (R. 07/92) WHITE - Issuing Jurisdiction YELLOW - DILHR • GREEN - Inspector PINK - Owner /Agent
ysaoe,
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DATE VS Y 7
NAME U� C�
ADDRESS
LOT ) BLOCK WARD
SUBO I V . V CGS • ���J2e6 ZONE
STREET NO. 3/57 i3eLfi 6 LIZ LOT DIMENSIONS
SIDEWALK EXISTING YES EJ NO El
BUILDING GRADE ELEVATIONS STAKES SET AT SITE (27 ? ,Ig 94 BY
FEE:
$15.00
?
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.
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4 KY 6
city Of Oshkosh 1/1/85
PARKLAND DEDICATION FEE COLLECTION RECORD
Address 3 ! � r '
Owner's Name
of Subdivision i--�- L-
Lot # Bldg. Permit #
No. of Units
Fee Required ` �J
r� .
Fee Paid 4 I un)
Owner's signature , 4•- . 1 Date g 9�
Inspector's signature NNW Date -
Parks Subdivision
Improvement
Accts. Rec.: 362 -041