HomeMy WebLinkAbout0039752-Building (parking lot) Wisconsin Department of Industry, PERMISSION TO START CONSTRUCTION Safety and Buildings Division
I abor and Human Relations
NOTE: This permission is applicable only to projects
having below grade foundation work.
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Additional fees are required. Contact one of the locations listed below for more information.
HAYWARD OFFICE LA CROSSE OFFICE MADISON OFFICE SHAWANO OFFICE WAUKESHA OFFICE
Route 8 2226 Rose Street 201 E.Washington Ave. 1053A E.Green Bay Street 401 Pilot Court
P.O.Box 8072 La Crosse,WI 54603 PO.Box 7969 P.O.Box 434 Waukesha,WI 53188
Hayward,WI 54843 Tele: (608)785-9334 Madison,WI 53707 Shawano,WI 54166 Tele: (414)548-8600
Tele: (715)634-4870 FAX: (608)785-9330 Tele: (608)266-8735 Tele: (715)524-3626 FAX: (414)548-8614
FAX: (715)634-5150 FAX: (608)267-9566 FAX: (715)524-3633
Project Location:
Street: E-Fi le:
City: Plan Number:
County: Date Plans Rec'd:
Occupanty: ..��,�t;s�.��i t" �; ��'r� �,,��. �, , _ _
We,the undersigned, request to begin footing and foundation work prior to approval of the plans in accordance with
.
ILHR 50.14.
Plans have been submitted to the Department of Industry, Labor and Human Relations,Safety and Buildings Division,and
all information requested by Code ILHR 50.12 or ILHR 50.13 has been included with the submittal.
We have reviewed the specific code requirements for the building or structure and its use,as set forth in ILHR 50-64,and,
where applicable, have shown compliance on the drawings.
We agree to make any changes required after the plans have been reviewed and to remove or replace non-code
complying parts of the foundation and/or footings.
We agree to proceed with the footings and foundation only and will not continue with the remainder of the building or
structure until approval has been received.
', We understand that, prior to the start of construction,a Building Permit must be obtained from the local authorities
having jurisdiction in accordance with their laws and ordinances.
We understand that if this project is in an unsewered area,a sanitary permit must be obtained prior to the issuance of
a local building permit(ss 101.12(3)(h)).
Owner's Signature: Designer's Signature: �
(Original Signature in Ink) ��" (Origina ig ure in Ink)
Date Signed: Date Signed: ;-;- � ;'f�,,,
Owner's Name: ; Desi ner's Name:
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Street: � ,
Street: l�.a`-s���� ;; J:��_
City: State: Zip: City: ��r r � State: Zip: {, � �
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'� Department Action: ��.pproved ❑Not Approved
� Review Comments:
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Reviewed By: � `. _ Today's Date
SBD-198(R.08/92)
; BLDG. INSPECTOR'S G"�PY
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DATE !.� 3 P PERMIT #�3� r�_� USE
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GENERAL CONTRACTOR �
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MASON .CONTRACTOR � ZONE
Width of lot DATE INSPECTIONS
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Front of lot MAILING ADDRESS