HomeMy WebLinkAbout0153812 - Building (driveway) CITY OF OSHKOSH No 153812
OSHKOSH BUILDING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 1104 MINNESOTA ST Owner RUBENNIRGINIA BORGARDT JR Create Date 10/16/2012
Designer Contractor VIENOLA BROS CONSTRUCTION INC(CONCRETE)
Inspector Nicole Krahn
Category 256-Residential Driveway Plan
Type • Building O Sign O Canopy O Fence 0 Raze
Zoning R-2 Class of Const: Size
Unfinished/Basement Sq.Ft. Rooms Height Ft. ❑ Projection
Finished/Living Sq.Ft. Bedrooms Stories Canopies
Garage Sq.Ft. Baths Signs
Foundation • Poured Concrete 0 Floating Slab 0 Pier O Other
0 Concrete Block O Post 0 Treated Wood
Occupancy Permit Not Required Occupancy Fee $0.00 Flood Plain Height Permit
Park Dedication #Dwelling Units 0 #Structures 0
Use/Nature RES/replace existing driveway and walkway per site plan submitted
of Work
II
I I
HVAC Contractor Plumbing Contractor
Electric Contractor
Fees: Valuation $1,800.00 Plan Approval $0.00 Permit Fee Paid $63.00 Park Dedication $0.00
Issued By: k Date 12/04/2012 Final/O.P. 00/00/0000
❑ Permit Voided Parcel Id# 0901050000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the easement
holder(s)and to secure any necessary approvals before starting such activity
I have read and understand the afore mentioned information.
Signature Date
Agent/Owner
Address PO BOX 8042 OSHKOSH WI 54903 - 8042 Telephone Number (920)303-0934
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection (i.e. Footing,Service, Final, etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
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r PO Box 1130
City of Oshkosh Oshkosh,WI 54903-1 1 30
Phone:(920)236-5050
Fax:(920)236-5084
Building Permit Application www.ci.oshkosh.wi.as
Project
Address / f/4a6 ,_c d - / .r
Applicant Owner Contractor Tenant Other(describe)
Owner/ Name Phone
Tenant
Address Email
Contractor Company Name 2c c'// --- j Phone .r"--7 Y7
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Contact Ai//✓1„' Email
Address A K erc''
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State Credential#'s ,
Dwelling Contractor Qualifier# Dwelling Contractor# Building Contractor Registration#
Achitect/ Company Name Phone
Designer
Contact Email
Address
Permit Type sidential Single Family Residential Duplex Commercial Multifamily Industrial
Catagory New Addition Alteration
Project "'LI^ 4/64/ Cfri(/e /, li" "
Description
Mechanical Separate permits will be obtained for the following:
Permits Electrical by Plumbing by Heating by
Value of Job $ 7,01 Value for materials&labor is req.to ensure consistency in accessing permit fees for all applicants.)
Payment by: Check # Cash Permit Fee Account
I certify the above information is complete and accurate. Any deviations from the above submitted information may require additional permits
to be obtained. I acknowledge and agree to these terms. /07/t--
Name: / /. 4!6;1�°'l� (Please print) Date:
Signature: i -