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SB-198
Rev.5/77
�
� DEPARTMENT OF INDUSTRY,LABOR AND HUMAN RELATIONS
SAFETY& BUILDINGS DIVISION •
P.O. BOX 7946
MADISON,WISCONSIN 53707
,
PERMIT TO START CONSTRUCTION
FEE $35.0�1(per bldg.)IN ADDITION TO EXAMINATION/INSPECTION FEES
Location of Project:
Owner:_ � Hl�'• ZAC. E
Street: WitZ�l AV� & �C�IB].1• �. P1an File Number
City: ��� Date Plans Rec'd
County: �f�
Occupancy: A�i�!!t �COII�II��}
We,the undersigned,request to begin footing and foundation work prior to approval of the plans. �
Complete plans have been submitted to the Department of Industry, Labor & Human Relations,Division of Industrial Safety and
Buildings,and all information requested by Code Ind. �0.12 has been included with the submittal.
We have reviewed the specific code requirements for the building or structure including,but not limited to,Ind. 54.01, Ind. 55.02,
Ind. 56.02, Ind. 57.01 (construction,height and allowable area), Ind. 50.12, Ind. 51.03, Ind. 53,Ind. 55.05 and Ind. 54.50,when
applicable,and have shown compliance on the drawings. .
We a ree to make an chan es re uired after the lans have been reviewed and to remove or re lace noncode com 1 in arts of '�
S Y g q P P PY� gP ,
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.
. � �T.�."�—.. ��I"` �� '� 'rs g 2�, `'S 1..,{; / �� :
`,� :;t 'f�,����'� ... � �f ti^.. y j � �
Owner's Signature �D Accepted By �+:' Date
Name: �i�l SC�Ott• '� ��'t�� Z�1C• Dept.of Tnd., Labor&Human Relations
�9�� � $1�• Div,of Industriai Safety&Buildings
Address: �
O�� � ��� Not Accepted Because
�'T � : t
_...,.,,.,.,�.�9,�ns will be examined within the next
Designer's Sign tuie Date days. �
Name: ��� �� .
�� �42 NOTE: Footing and foundation plans submitted prior to
Address: p'o" final building plans will not be accepted for this permit.
Qre�t B�tp. 1�T 543�3
!P�!'C�.,"'.:P�r�Ji :-�f�a+.
_:.�.��iS. :s ... a'_ ;p ��.
.
. �
DHTE ���—h'�
NAME �'� . ADDRESS �9c3
LOT � /�I O/` S!�/�/ Sc c .� BLOCK WARD �j
SUBDI V. �1 ri-�P_,� � ZONE � —�
STREET NO.��—��� ���� LOT D I MENS I ONS�D�,�Y ��I
SIDEWALK EXISTING YES NO L..�
�
BUILDING GRADE ELEVA� STAKES SET AT SITE , 19 BY
FEE: $2.00 /l� � .. �� •7� /l�E� •� /YE� �� -SIt/� S •�
I�v .�os; s3 �� t'. �S3•3
„��7ss. � e x c s iS S' � �
DEPARTMENT OF PUBLIC WORKS
I , the undersigned, owner or agent of the above described property agree to have the
grade established before excavation has commenced .
: ;h:�'a
<..o.