Laserfiche WebLink
Permit #16252 <br /> Wisconsin Department of Industry, WISCONSIN ADMINISTRATIVE Safety and Buildings Division <br /> Labor and Human Relations BUILDING PERMIT APPLICATION <br /> (Wis.Stats. 101.63(7) & 101.65(3)) <br /> Submit to non-enforcing municipalities for new 11-and 2-family dwellings. See instructions on back of yellow copy. <br /> 1: X: <br /> PgWARILI <br /> Last Name First Name Middle Initial <br /> 9RaLK7- _'7'.5 . <br /> P <br /> reet Address <br /> City State Zip Code Telephone No.(include area code) <br /> eU ka 416 e 73 )3 <br /> .1...... <br /> % <br /> �xx <br /> ......... <br /> 00.1 <br /> Building Address Subdivision Name Lot# Block # <br /> CSM V.2 P.44 I <br /> 49option Parcel No. <br /> 1/4, 1/4, Section 18 T 38 N, R 14W E or W 08-2118-03-300 <br /> . ............ .1'- .0 N <br /> ............. <br /> ENT <br /> ,PMEtf <br /> 0_10IIPM N <br /> l]3�T Family E] Forced Air Furnace adiant Baseboard or Panel (Elec.) E] Heat Pump <br /> n 2 Family E] Boiler E] Central AC El Other: <br /> K:,PROXCT NERGYSOPOCV: Nat. Gas L.P. Oil Elect. Solid Solar <br /> Space Heating 0 0 El0 El <br /> Water Heating ❑ El El El ❑ <br /> YOE: CNPIROX ..... <br /> :4 PRO 99_0111110t RKTM T <br /> H M: <br /> RfSite Constructed E] Concrete asonry El Treated Wood <br /> E] Manufactured F1 Other: <br /> PROJECTAREA <br /> G C, ST, <br /> ........ <br /> Living area = C, 0 Square Feet $ 24_0 0050 <br /> 1 present that all the above information is correct, and understand that the issuance of this permit is for <br /> administrative purposes only. Onsite construction inspections will not and shall not be performed by the <br /> municipality which has not assumed jurisdiction per s. 101.65, Wis. Stats. I understand the Uniform Dwelling <br /> Code, Chapters ILHR 20-25,still applies to all new I-and 2-family dwellings and must be complied with. Irealize <br /> the issuance oft , ermit does not relieve me of compliance with other applicable codes and ordinances. <br /> 4�,> P�� �, s_/1 2192 <br /> 'Applicant's Signature Da"te Signed <br /> MUST BE COMPLETED BEFORE SUBMITTING TO DILHR: <br /> ISSUING: It 0 C]Town ❑ Village ❑ City of: Dewey <br /> 31, , S. ct <br /> J0 <br /> MUNICIPAM NUMOER.:z # 0 7 0 0 8 None <br /> BY:;, Zoning Office <br /> PERMIT I$U.N. 5/18/92 <br /> SBD 8254 IN 09/89) White-Issuing Jurisdiction Pink-DILHR Within 30 Days Yellow-Applicant <br />