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� CITY OF OSHKOSH No 0075623
OSHKOSH BUILDING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2461 SECURITY DR Owner SECURITY HOMES Create Date 02/10/2000
Designer Contractor SECURITY HOMES OF WISCONSIN INC
Category 110-New Single Family Plan C8-010-0200R
Type � Building � Sign � Canopy � Fence � Raze I
Zoning R-1 Class of Const: 8 Size IRR
Unfinished/Basement 1873 Sq.Ft. Rooms 7 Height Ft. ❑ Projection
Finished/Living 1873 Sq.Ft. Bedrooms 3 Stories 1 Canopies
Garage 528 Sq.Ft. Baths 2 Signs
Foundation Poured Concrete � Floating Slab � Pier � Other
Concrete Block 0 Post � Treated Wood
Occupancy Permit Required Flood Plain No Height Permit Not Required
Park Dedication Required #Dwelling Units 1 #Structures 1
Use/Nature SFR/1 story home w/2 car attached garage,NO DECK OR PATIO.
of Work
HVAC Contractor BREWER HEATING Plumbing Contractor JIM'S PLUMBING
Electric Contractor CUMINGS ELECTRIC
Fees: Valuation $82,000.00 Plan Approval $40.00 Permit Fee Paid $280.00 Park Dedication $100.00
Issued By: Date 02/29/2000 Final/O.P.
� Permit Voided I
In the performance of his I a e to all work pursuant to rules governing the described construction.
Signature � Date Z Z�� ��
AgenUOwner
Address 100 N WESTHAVEN DR OSHKOSH WI 54901 - 0000 Telephone Number 414-426-2045
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OSHKOSH GRADE STAKE FORM
ON THE WATER Grade Stake Number 6319
Name SECURITY HOMES Address 2461 SECURITY DR Create Date 02/10/2000
Lot 36 Block Ward
Subdivision Country Side Est North Zone
Street Number Lot Dimensions Sidewalk Existing
Building Grade Elevation Stakes Set At Site 02/14/2000 Set By D.W.G. BK-549, P-73
Department of Public Works
I,the undersigned, owner or agent of the above described property agree to have the grad esta lished before excavation
has commenced. C�2/�
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Wisconsin Department of Industry, WISCONSIN UNIFORM Application No.
Labor and Human Relations
Safety and Buildings Division BUILDING PERMIT 0075623
P.O.Box 7969 APPLICATION Parcel No.
Madison,WI 53707
Wisconsin Statues 101.63, 101 J3
❑✓ Constr � HVAC � Elec � Plbg �✓ Erosion � Other:
Owner's Name Mailing Address Telephone No.
SECURITY HOMES 100 N WESTHAVEN DR Oshkosh WI 54901 - 0000 426-2045
Contractor: ✓ Con Elec HVAC� Plbg LiGCert# Mailing Address Telephone No.
SECURITY HOMES OF WISCONSI 8549 100 N WESTHAVEN DR OSHKOSH WI 54901 - 0000 414-426-2045
Contractor: Con ✓ Elec HVAC Plbg Lic/Cert# Mailing Address Telephone No.
CUMINGS ELECTRIC PO BOX 749 NEENAH WI 54957- 0749 231-5946 (Dick
Contractor: Con Elec ✓ HVAC Pibg LiGCert# Mailing Address Telephone No.
BREWER HEATING N8804 N DOUGLAS ST RIPON WI 54971 - 0000 1-748-6494
Contractor: Con Elec HVAC ✓ Plbg LiGCert# Mailing Address Telephone No.
JIM'S PLUMBING W-6166 GREENVILLE DRIVE GREENVILLE WI 54942- 0000 757-5258 OR 7
LotArea S .ft. 1/4, 1/4,Section ,T N,R E(or)W
Building Address Subdivision Name Lot No. Block No.
2461 SECURITY DR Country Side Est North 36
Zoning District(s) Zoning Permit No. Front Rear Left Right
�✓ New � Repair ❑✓ Single Family Entrance Panel �✓ Forced Air Fumace Fuel Nat. L.P. Oil Elec. Solid Sola
� Alteration � Raze ❑ Two Family Size: 200 am ❑ Radiant Baseboard or Panel Gas *
� Addition � Move ❑ Garage Service: ❑ Heat Pump Space Htg ❑ ❑ ❑ ❑ ❑ ❑
❑ Other(print): ❑ Overhead � Boiler Water Htg �✓ � � � �
�✓ Underground Central Air Conditioning ,
❑ Other Dwelling unit will have 3 kilowatt or
Other more installed electric space heating equip.
�✓ Site Constructed ❑✓ Concrete Infiltration control option is:❑ Fuli sealing
Unfinished ❑ Manufactured � Masonary Sewer of joints. ❑Blower door test. ❑Exterior
Basement 1873 Sq.ft. ❑ Treated Wood � Municipal air infiltration barrier.
✓ 1-Sto ❑ Other � Septic
Living Area 1873 Sq.ft. ❑ rY
❑ 2-Story Permit No. Envelope 30470 BTU/HR
Garage 528 Sq•n• � Other Seasonal Infiltration 11463 gTU/HR
�✓ Permanent
❑ Other ❑✓ Municipal Utility
�✓ Plus Basement ❑ Private On-Site Weli $105,000.00
The applicant agrees to comply with all applica es, tatues and ordinances and with the conditions of this permit,understands that the issuance of
the permit creates no legal liability,expre r i i d, he De ent nicipality;and certifies that all the above information is accurate.
APPLICANT'S SIGNATURE C� DATE SIGNED Z"Zf�—�
APPROVAL CONDITIONS This permit is i sued pursuant to the following conditions. Failure to comply may result in suspension or
revocation of is permit or other penalty
see standard conditions of approval
� Town � Village � City � County � State of: Municipality Number of Dwelling Location:
City Of Oshkosh 7 0 - 2 6 6
Plan Review �o.00 ✓ Construction
Inspection
HVAC Name Nicole Krahn
wis.Permit Seal $30.00 Electrical Date 02/10/2000
Plumbinq
Other ✓ Erosion
Tota1 $70.00 233853 Cert.No. 248101
SBD-5823(R.07/92)
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OSHKOSH PARKLAND DEDICATION FEE COLLECTION RECORD
ON THE WATER
Job Address 2461 SECURITY DR Date 02/29/2000
Name SECURITY HOMES
Address 100 N WESTHAVEN DR Oshkosh WI 54901
Subdivision Country Side Est North Lot 36
Building Permit Number 0075623
Number of Dwelling Units 1 Number of Structures 1
Fee Required $100.00 Fee Paid
Owner's Si nature ���l�%✓w c.�� DateZ�Z ��
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Inspector's Signature Date :
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SECURITY H�MES INC. OF WISC�NSIN
i N FOX VALLEY DIVISION
s� .ios ►u�x m►re
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�� LOT 36 - CWNTRYSIDE ESTATES N�RTH
SECURITY DRIVE
�SHKOSF�, VISCONSIN
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� CORRECTION NOTICE / FIELD INSPECTION REPORT �
City of Oshkosh JOB LOCATION: p���?� ��Z.�,.',t�-�`� i��
Inspection Services Division
215 Church Avenue,PO Box 1 l30 CONTRACTOR: ����\,J�S"C"
Oshkosh,WI 54903-I 130
Phone:(920)236-5050
Fax(920)236-5084 PROJECT TO BE INSPECTED: f��
BUILD(NG: HVAC: ELECTRIC: PLUMBING: EROSIOV CONTROL: PROPERTY MAINT.:
Footing Rough Rough Rough Tracking Setback Park.
Foundation Furnace Service Tes[On Sil[Fence Unlicensed Veh
Rough A/C Temp Perm Underfloor Stone Access Garbage
Insulation Fireplace UG OH Sewer/Water Straw Bales Dilapidated bld's,fences,
Re-insp. Re-insp. / Re-insp. Re-insp. Re-insp. etc.
Final Final Final Final Final Ext.Maint.
ITEM# CODE INSPECTION RESULTS
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VIOLAT[ONS MUST BE CORRECTED AND APPROVED WITHIN 30 DAYS UNLESS OTHERWISE NOTED. CALL FOR RE-INSPECTIONS PRIOR TO
CONCEALMENT AND/OR OCCUPANCY. WHEN CORRECTIONS ARE COMPLETED THE OWNER/CONTRACTOR IS REOUIRED TO SIGN&DATE THIS
NOTICE AND RETURN IT TO THE INSPECTION DIVISION WHEN REOUESTING A RE-1NSPECT[ON.
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COMPLIANCE DATE: `��.AL_ l 1��"ri� ��.1� l�( ' ,(� ��+;�i''� ,`� ' L._l_-_.�
' ACTION TAKEN:
❑ Not Approved/Insp. Report left on site ❑ Not Approved/Insp. Report given to ❑ Mailed/Faxed
Signed � ��(�t, -------__? 1 � i �Q�� ���C'.�����-,
—�nspection Services Division Date of Inspection Phone#
I hereb certif that the violations at the above address have been conected.
CONTRACTOR/OWNER SIGNATURE DATE