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HomeMy WebLinkAbout0016817-Building (raze) CITY OF OSHKOSH N2 16817 PERMIT - APPLICATION AND RECORD W r cre:,k_rc • � �/ TYPE: BLDG [1] HTG ❑ ELEC ❑ PLBG [1] SIGN ❑ ZONING Z FLOOD PLAIN S'_ HEIGHT ADDRESS oa ©' ( NAI fc s Ci 7-4 Sr PLAN NO. OWNER L ccA OA_ brit/ ((.ronnniLJ j 1 Z S - n2t,t'.cCt") , DESIGNER � USE /NATURE OF WORK sm�N�c - IC <- °l t � '" L � c t 4./cA a2A- 4t, Sdc--- BUILDING CO»TRACTOR L C4 ° „ T d A.1 S"?n Size k 40 Sq.t. U # Rooms S �` ( Ti# # Stories / Height / Foundation C 0 StS Class of Const. ? Occupancy Permit 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 L` 6 ` k(frA T BT WH Disp WSoft CBasin Lav Sh DW DF San. Sewer WC FDr SP Ur Storm Sewer Sink LTub Eject SS Water Other FEES: Valu• on + i Permit Fee Paid $ /0 ✓ Park Dedication $ Aj/ ISSUED B ` .f., .- . .., Date /, 2 - p® Final /O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. ... t /J SIGNATU - E . _' ✓: A' _1__/ a 67 v AGENT/OWNER �/ J�//�� 7 ` ATE c ADDRESS �� �J / X i ` "�"��� ,.,/�''4'G7 01 J (' / d"` TELEPHONE # RECORD OF SEWER AND WATER DISCONNECTIONS Date 1 — 9' Address of Building 20 0 Z / 1'jes'd", . Name of Owner ,4 L "C /L-i .Z A = i vu v c.c 7 Address of Owner 2 90 7 6 , ' - ` - 1s^ - Sewer Sealed at Property Line /2,4-Y 19 b I ' ' / Water Disconnected at Property Line / 219,aby G`r;- 7 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 services will be disconnected and sealed by a master plumber on or before Cf` , (Owner (Agent Approved for issuance of wrecking or moving permit. //i/l4a Date u ing Inspector