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CITY OF OSHKOSH N 42628
PERMIT - APPLICATION AND RECORD
TYPE: BLDG 'HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS Wok) e06 y • PLAN NO
OWNER FA/ 1, 1 oCi
DESIGNER
/ fi /
USE /NATURE OF WORK 1 / ✓ A V A _ /
-
BUILDING CONTRACTOR 4-Ch (316 C-4C
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. g Occupancy Permit /V
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
- BT _ WH _ Disp _ WSoft _ CBasin
- Lav _ Sh ._ DW _ DF — San. Sewer
WC _ FDr SP Ur — Storm Sewer
Sink _ LTub _ Eject — SS _ Water
Other
cl'2 GC / ,—
FEES: Valuation ill' e i .. ` Permit Fee Paid $
Park Dedication $
ISSUED BY Aetar'i /_../ Date MET Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
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SIGNATURE .�i%►, // /1 � /
AGE �rWN5 OA
ADDRESS ' 1- 7L(7(... T
TELEPHONE #
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ZONING/ /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: '2 « J /10/u)e ZONING
P ROPERTY OWNER/CONTRACTOR: / 7 / 7--/i Requa4
CONSTRUCTION DATA: )e New Construction Addition Alteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.)
l�X Pik!
COMPLIANCE CHECKLIST
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
Compliance with P.C. or
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.
X APPROVED DENIED
Plan Commission Action Required
Variance(s) Req • .' 0
REVIEWED BY: AMY ' , firor DATE: //Mew
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Archadeck of the Fox Cities/Telephone (414) 231-7476/(800) 653-DECK (3325)/Fax 1414) 231-7636/P.O. Box 753/Oshkosh, WI 54902
OWNER A l ph / �► i l ;l.C°,il ADDRESS 1 --i`f lnm (ne
DATE �� ���I PERMIT #! io USE 31 R
kr W - s consists of I) � Xr()1 `roar
GENERAL CONTRACTOR , .� k Q 0,
MASON.CONTRACTOR • ZONE
Width of lot DATE INSPECTIONS
Fl
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9-4 V
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Front of lot MAILING ADDRESS