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� CITY OF OSHKOSH N°- 45343
� PERMIT - APPLI ATION AND RECORD
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TYPE: BLDG�HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS /�l� � 4cI�� OG� PLAN NO.
OWNER �G/`�C �E.�e�jh ILl°
DESIGNER
USE/NATURE OF WORK � �� �- ' �
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BUILDING CONTRACTOR � �lt.! �9-aL'�cc.a ,LS os r�d�e/`S
Size 1� � Sq. Ft.� Z� # Rooms � # Stories ` Height ��� ��
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Foundation � Sr�` �'� �X8 G'r�+' Class of Const.—� Occupancy Permit���
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HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ FueUSystem Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
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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
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FEES: Valuatio Per ' ee Paid $ � Park Dedication $ "'�
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ISSUED BY Date Final/O.P.
In the pertormance o ' work I agree /perform all work pursuant to rules governing the described construction.
SIGNATURE �
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AGENT/OWNER DATE
ADDRESS i S 19 �ACI�S o.J t�2,�-�O S 7�
TELEPHONE N
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ZONING/LAND USE COMPLIANCE CHECKLIST
JOB LOCATION: �,�/� �_c_�tsnr� ZONING
PROPERTY OWNER/CONTRACTOR:
CONSTRUCTION DATA: New Construction Addition Aiteration
TYPE OF CONSTRUCTION: (i.e. fence, pool, parking lot, sign, etc.)
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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.
� APPROVED DENIED
Plan Commission Action Required
Variance(s) Required
REVIEWED BY: DATE:
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