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CITY OF OSHKOSH H°- 39 181
n PERMIT - APPLICATION AND RECORD
TYPE: BLDG pcf. HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS I gac ‘f' 4/. Y f1 m PLAN NO.
OWNER 7/'C A.)/j /l .0672 vvi/■J
DESIGNER
USE/NATURE OF WORK
aF ) Co,iS i R T ,Y i X 4 ' 2771C/ 6t)
0y q/2A6c-. ( *zc 'rsri,G /8'a zc i 64/1/46&)
BUILDING CONTRACTOR G— , )/ci oxie/Qcs
Size X2 (— Sq. Ft. S 76 # Rooms # Stories C Height �/
Foundation C�;ti'�` --C2A6 — Class of Const. Y Occupancy Permit NO
C44 :l f iog" ktE ij4)
HEATING CONTRACTOR `% C
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
_Lay —Sh _DW W DF —San. Sewer
_WC FDr SP Ur _Storm Sewer
_Sink _LTub Eject —SS Water
Other
FEES: Valuation $_ 4 Permit Fee Paid $ 40' Park Dedication $
ISSUED BY
Date gid4y Final/O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
--- 11)--2 6?.‘)/9.V.
SIGNATURE,, - AGENTiOWNER 9 DATE
ADDRESS—_/ 4yd) .4, Ail ,4 - .Z : 51yia� TELEPHONE
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Revised: B/L
ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: ( 3 6 ),44,1- 4 41/'I r, ONING:
PROPERTY OWNER/CONTRACTOR: E-til /(/k)L.4 / RNLr 64/34e6-7,3
CONSTRUCTION DATA: ! NEW CONSTRUCT:{4 ADDITION ALTERATION PARKING LOT
''''''TYPE OF PROPOSED CONSTRUCTION: (i.e. fence, pool, WTI, deck, etc.)
X C 1/1 _l'-"T4-/ <D 6-4R4 GE 4 (� r �x 577N6 640A66---=
77)
COMPLIANCE CHECKLIST (Check only those applicable)
COMPLIES DEFICIENT DEFICIENCY/COMMENTS
_ Use
_ Lot Width
_ Lot Area
_ Floodplain
Front Yard
_ Side Street (fnant 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 w'thout referral to the Director of Community Development, or designee.
APPROVED _ DENIED
Plan Commission Action Required
Variance(s) Require 7
REVIEWED BY: /'. AIM DATE: 6ffir