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HomeMy WebLinkAbout0010247-Building (raze house) CITY OF OSHKOSH No 10247 PERMIT — APPLICATION AND RECORD xcg we TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING f FLOOD PLAIN HEIGHT ADDRESS `� i`�ca29 V-- PLAN NO. OWNER 1 --'r 0 LA. P -QkE DESIGNER USE /NAT RE OF WORK & C i - t r BUILDING CONTRACT R d'ta� Size > f Sq. Ft. # Rooms # Stories________ Height Foundation Class of Const. t Occupancy Permit / is HEATING CONTRACTOR Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S ELECTRIC CONTRACTOR `�— Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR c" ► ----5 66 b4' BT WH Disp Soft CBasin _Lay Sh DW DF San. Sewer WC FDr SP Ur Storm Sewer Sink _ LTub Eject SS Water Other �' v° • FEES: Valuation � e P a i d $ © Park Dedication $ ISSUED BY r / / 17s ,i , �/ �? A ll Date 7 i3 - Final /O.P. In the performance of this work I agree tc ., orm all work pursuant to rules governing the described construction. SIGNATURE N )L AGENT /OWNER DATE 4 eAel'ef / DATE ADDRESS + 1� A"' ji 2e, ,,4 ' 6 y TELEPHONE # RECORD OF SEWER AND WATER DISCONNECTIONS Date 7 — E--- 04 Address of Building 4.23 g ,�✓ Name of Owner 6 a 2 _c. S /t Address of Owner A,,3 "- / z' r C /... Sewer Sealed at Property Line 9? 19Lby ddi/kg e�r4 Water Disconnected at Property Line F/ 19 y tc No sewer and water services to premises. E I, the undersigned, owner or agent of the above described property, agree that all sewer and water se ices will be disconnected and sealed by a master plumber on or efore er 1 14:) Approved fo issuance of wrecking or movi - - .,•it. 44EIBTK' e Af7u..ing nspector _.__