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CITY OF OSHKOSH N2 33122
'`' PERMIT — APPLICATION AND RECORD
TYPE: BLDG HTG ❑ ELEC
❑ PLBG ❑ SIGN ❑ ZONING ie- Z FLOOD PLAIN HEIGHT
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ADDRESS / 4 O 9 ByIJ0.C. PLAN NO. El 3S o393,2...
OWNER At...a.!
DESIGNER nn /��
USE /NATURE OF WORK »1(4) Dli, a�'. ,t -
BUILDING CONTRACTOR Ab ll-1
Size Sq. Ft. g70 # Rooms — V4Y # Stori Height Z 0 "
Founda iTon ie e sl Class of Const. a Occupancy Permit 1 .
HEATING CONTRACTOR fk�G0C `6.. li1✓
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 0640
BT _. WH Disp _ WSoft _ CBasin
- Lav Sh DW DF San. Sewer
WC _ FDr SP Ur Storm Sewer
- Sink _ LTub Eject SS _ Water
Other
FEES: Valuation $ 6, D OOD . Op Permit Fee Paid $ /10. ea Park Dedication $
ISSUED BY il
�►". .. vr, Date 3 / 2 - 3 /5 1 3 Final /O.P.
In the perfor .nce of this rk I a r . .erform all work pursuant to rules governing the described construction.
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SIGNATUR'
AGENT /OWNER DATE
ADDRESS
TELEPHONE #
Revised: 8/89
ZONING /LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: / 1 O 9 %' p q if ZONING: 1 L.--
PROPERTY OWNER /CONTRACTOR: Lt jiad
CONSTRUCTION DATA: ,AEW CONSTRUCTI{N ADDITION ALTERATION PARKING LOT
TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, sign, deck, etc.)
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COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY /COMMENTS
_ Use
• Lot Width
_ Lot Area
_ Floodplain
_ Front Yard
_ Side Street (front 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
REVIEW 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 complies with the above criteria, the permit can be reviewed by the
Building Inspector without referral to the Director of Community Development, or designee.
L ' APPROVED DENIED
Plan Commission Action Required
Variance(s) Require.
REVIEWED BY: i__' '
DATE: ,y
6 3s 0-59 g--
Wisconsin Departmentof Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations BUILDING PERMIT 3312-2-
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 REQUESTED
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:ii: •
1 ;:i:ijkfc t 0 HVAC 0 Elec 0 Plbg A 0 Other:
Owner's Name Mailing Address Telephone No. (include area code)
Contractor's Na e Mailing Address Telephone No. (include area code)
■.A G zo, 3,4d drAttiesok
::::::;•:;::::::::iii:::;:ii:::::ii::i Lot Area
MPROJECULOCATIOIrii
::::::::::::::::;:;:::::::::::::::::::::::::::::::WM:::::::::gi;:::::::::::::;:::::::::!:::::::::::::::::::::::::•; Sq. ft. 1/4, 1/4, Section , T N, R E (or) W
Building Addres _ Subdivision Name Lot No. Block No.
1 P
Zoning District(s) Zoning Permit No. Front 1 Rear Left ( Right ,,,
ee--2-- Setbacks .2 5 ft. j 52-- ft . 41' ft. 7 7 2, ft
1 PR141E..: , iii:Mi::ii:::::M:M:•::t . ::: . i::.:I::iil:ii. iiia:::: : .1: ' ' ' :i:::::: :::12REH'i ''' ' ...CiAL:::::::a9ii.ii:11VACIE ' IPMEtiti:::::::142NOVER . 16 ,' :, It
:'..'• ew 0 Repair 0 Single Family Entrance Panel ' 0 Forced Air Furnace F Nat. L. P. Oil Elec. Solid Solar
0 • Iteration 0 Raze )20 Family Size:21 amp 0 Radiant Baseboard or Panel uel Gas
fl Addition 0 Move (D Garage Service: 0 Heat Pump Space Htg 0 0 0 0 0
0 Other (print): )6Underground oiler
Overhead entral Air Conditioning Water Htg 0 0 0 0 0
0 Other
MICONSIIITYPE::::: :...i.::::::i:FOUNDATION f=1 °ther * 0 Dwelling unit will have 3 kilowatt or
more installed electric space heating equip
.......„.....,.... . .. ............„....„..........................._. .
KW Constructed •:4 Concrete MP Infiltration control option is: 0 Full sealing
M anufactured • of joints. 0 Blower door test. 0 Exterior
i2Z4/.4REAINVOINEV::;:;:::::::::::::::::::::::::::::: 0 P T r a e rt e r d Y Wood Sewer
ttitIEV::: air infiltration barrier.
0 other Municipal
Unfinished Basement 0 Sq i
. ft ''' ''' . 4 " ::::• • • ' :::"%%%:'''''''''''''::::''' f$ '''''''''''''''''''''''''''''''''''''''''''
. ................ Septic
0 1- Story iSigUSEMi:ii::i:i:i:iii:i:i:i:i:i:i:]Ii:i:i1i:i p N
Envelope 2-4 BTU/HR
Living Area 0( Sq. ft- 0 2-Story 0 Seasonal ' . '''''''''
''''' ..... -,.. ' . .......................................................
A:iiii:WIRtt•ii,:i:::.:iiiiniiii:i.:WiRii::i:::::::::::::: Infiltration 2 - citqo BTU/HR
Garage evz-ii- Sq. ft, .d Other _ . t' ermanent
• _ AM!'" 0 Other XIN•lunicipal Utility 14 0.0.t 0410000Stagni$1
9P , s Basement 0 Private On-Site Well $ 7 S; 000 . 0 0
The applicant agrees to comply with al a r.dicable c i ' es. st,,, ordinances and with the conditions of this permit; understands that the issuance of
the permit creates no legal liability, ex • •-ss or im/d, • 4 / , .epartment • - . icipality; and certifies that all the above information is accurate.
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APPLICANT'S SIGNATURE " • DATE SIGNED
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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h4 440.v., efrx.A..a /6. et4 , ce/1,i- -
itioii40 1 0 Town 0 Village Aeity 0 County 0 State of: Municipality Number of Dwelling Location:
.JURISINCTION i: ' 2_ 0 -
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SSIJED::::::::':',:::1:::::::::::::::Semai00:::::::11::::::::::::::::::::::::::::::::::.ii::::::::::::::::::::&:::::::::::::::::::::::::::::,:::::::::::::::::::::::::::::::::;:::::::::::::::::::::::::i::::ii::1:;:;:iiili:::::::::::::i.1:::i:::!:::i;:ei:::::::::::::01:i:1:i:::::1:::::1,'Iiig:::i:i:::
Plan Review $ Q. 00 . onstruction I.
Inspection $ a VAC Name
iiirior•VS•4424.4/14....,--
Wis. Permit Seal $ 30,6 /0 0 Electrical ( zifis7 5c
Other $ 0 Plumbing Date 43/9'3
?f rosion
Total $ 7D 0 . O Cert. No. 6
SBD-5823 (R.07/92) WHITE - Issuing Jurisdiction YELLOW - DILHR GREEN - Inspector PINK - Owner/Agent
DATE 3/Z 3/93
NAME /)giU ADDRESS
LOT BLOCK WARD dfiD
SU8OIV• ZONE
STREET NO. / �0 9 � /V09I 174 - LOT DIMENSIONS
SIDEWALK EXISTING YES 0 NO 0
BUILDING GRADE ELEVATIONS STAKES SET AT SITE ,I9 BY
FEE; $15.00
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DEPARTMENT OF PUBLIC 'WCRKS
I, the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced.
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0 STRAW BALES
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_ _ PROPERTY LINE