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DEPARTMENT OF PUBLfC WORKS I , the undersigned, owner or agent of the above described property agree to have the grade established before excavation has commenced . , ,� !, • • a��� ��j � �� �� � . :� � STATEOFWISCONSIN WISCONSIN UNIFORM IaB�f 3 �uiuN qEU oo�owrnr,ueon�NO P ER M I T N O. DIVIEIONOflAFTYANOBUILDINGS BUILDING PERMIT Tol E.WAfMINGTON AVE. PARCE L NO. eox� ""°"°"."".�"°' APPLICATION WItCOMSINSTATUE!101.E3 PERMIT REDUESTED coNST v,ac ec ��+s- Ow r's Name Mailin Address Telephone ��.2R �'a�s I Sr 3 S- 1 t3 t z.� Contractor's Nam Mailing Address Telephone �AM�- � �-- �A,1��— PROJECT LOCATION v. ��<, sECr�on, , T n,, R Elor►W Building Address Su division Name Lot No. Block No. I Z 1 Z �,�,. �Z.z�l.�J�,. �.2��� �oM�s �1� -- Zo i�g District Lot Area Front Rear T Left Right �-- ( g ���O Sq.ft. Setbacks '�°� ft. gJ ft. ft. � ft. 1. PROJECT 2. TYPE 3. ELECTRICAL 4. HVAC EQUIPMENT 5. ENERGY SOURCES Entrance Panel orced Air Furnace Fuel �° Wacer �New ❑Addition Single family '�� AMP Htp. Htp. SiZe' Radiant Baseboard or Panel ❑Alteration Two family Service LP Gas � .�❑_ ❑Gara e ❑Other ❑Heat pump � 9 � nderground �goiler Nat.Gas ❑Attached Overhead Fuel Oil ❑ ❑ ❑Detached ❑Central Air Cond. O ❑ 6. CONST.TYPE 7. FOUNDATION ❑Other Elec. ❑Other 'A $3�O Wood ❑ ❑ ❑Master plan no.�r� Site const. oncrete (if applicable) 8. PLUMBING Solar ❑ ❑ ❑Manufactured Masonry Coal ❑ ❑ outida ❑Treated Wood Sewer 9. AREA 10. STORIES Other Dimension ❑Other ��llunicipal u Septic �Basement �sq.ft. 1-Story 11. USE ❑permit No. 12.WATER ,^� ❑2-Story �Living Area �_�v sq.ft. ❑Other �Seasonal Private �ermanent �Other �Municipal e applicant agrees to comply with the Wisconsin Uniform Dwelling Code and other Municipal Ordinances and with the conditions of this permit;understan s that the issuance of the permit creates no legal Iiability,express or implied,on the Department or Municipality;and certifies that all the above information is accurate. SIGNATURE OF APRLICAIdT DATE 5��—°8 3 CONDITIONS OF APPROVAL Tn'S ermit is issued pursuant to the following conditions. Failure to comply m�y result in suspension or revocation of this permit or other penalty. ' �. , n /��L.S �L 1/ /� T TIF 6LS /l1JA�iE�t/'tAC, -r �C.. « r�,'rKJL, � . r i2C� C�b�-_ 1S. ISSUING JURISDICTION ❑VILLAGE ITY ❑TOWN ❑COUNTY ❑STATE NAME ����S� MUNIC. NO. � � — � � v FEES PERMITIS) WIS.UNIFORM PERMIT �� ISSUED SEAL No.ls1 PERMIT ISSUED BY PLAN REVIEW � $ � ONST. � t NAME � iNSPECTION HVAC �f'�e �� .� �_�� WIS.PERMIT SEAUS) K�ELEC 3 DATE OTHER( ) � CERT NO. ��� (t� TOTAL$ DILHR-SBD-5823 ISSUING JURISDICTION/AGENCY < OWNER��C'�CE�'�./L,�-t�-�-15 �US�-- ADDRESS (�� L w� iZ`�—`' ��� DATE �-Z-4 - 8 3 PERMIT # � �t'� USE ��F/�-- # ��`�--t-�-'" Wor k c o�s i s t s o f/,��u.�� GENERAL CONTRACTOR � � �� ; MASON CONTRACTOR ZONE Width of lot S�� DATE-�z.�3,c=��'��' INSP�CTIONS REMARKS .. �j S �1 �!.L r �..__- � !�S � g � Ui1�0 719 �%c'� ':. r � �+ pll6_ 1 2 1983 .C�O Q � �- i � � � f r., � �'j ` - o .� � � � � a m A - - �Z� � Front of lot MAILItvG aDDRBSs � Feb. 14, 1984 Jerome & Francis Faust 4180 Knapp St. Road Oshkosh, WI 54901 CEETIFICATE OF OCCIIPANCY 9n Occvpancy Permit is hereby granted for tne new house located at 1212 W. 12th Ave. OShk03h� Wisconsin as described in 3vilding Permit application numbers(s) 12843 . 2'P11S building 1S t0 be used 0211� SS a single family residence and is 1II the R-1B Single Family Residence Dis�r2ct. LI�ITATIONS: �+Iaaimum floor ZOSd1IIg: 40 pounds per square foot live loading :4aaimum number oP persons andi or Iiving uni�s: one 1i�ing unit NOt�: A new Certificat2 oF Occu�anc� shall be required prior to occupa,ncy, should additional building(s ) be erected, or shvuld any bulldings mentioned above be altered or oo�ed. The use of land, or buildings shall not be changed unti7. a Cert�:'ic�te of Occur�ancy is issued Por that occupar.cy. CHTEF BUIiDING I1TSP�CT08