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Permit 1116365 <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 1-and 2-family dwellings. See instructions on back of yellow copy. <br /> x,2 <br /> P1.10%AQPIJCANT <br /> Last Name First Name Middle Initial <br /> Street Address <br /> 55 54v;e%,,LJ Lafi e, <br /> City state Zip Code Telephone No.(include area code) <br /> r ver I Milo .5531 - 464;) 4 q,?-cQ cxo 13 <br /> xx:N <br /> .... ........ <br /> .. . ...... .... _NX <br /> ........... <br /> -K ..... <br /> . ..... ..... <br /> gX . .... <br /> N. <br /> Building Address Subdivision Name Lot# Block# <br /> 67 Ve <br /> 007 IPardun's River Pines 32 <br /> Legal Description No. <br /> 1/4, 1/4, Section T 40 N, R 16W E or W Parcel I <br /> 20-9135-04-200 <br /> 7: AROIEGT TYPE'; 2. PR fJEC1 HVAC EQUIPME, <br /> UU­ <br /> I Family U Forced Air Furnace 25 Radiant Baseboard or Panel (Elec.) ❑ Heat Pump <br /> ❑ 2 Family E] Boiler ❑ Central AC ❑ Other: <br /> %.,..PROTECT,,.ENERGY Nat. Gas L.P. Oil Elect. Solid Solar <br /> Space Heating 11 El El ❑ El <br /> Water Heatin 1:1 r7l n El El <br /> R ...... <br /> P Om <br /> K <br /> No <br /> 1j;jrSite Constructed ❑ Concrete ;"asonry 0 Treated Wood <br /> F1 Manufactured 7 Other: <br /> 'DING. S, <br /> P E �P. <br /> ,6 PROJECT <br /> 7L <br /> Livina area = 7& y Square Feet <br /> I 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 1-and 2-family dwellings and must be complied with. Irealize <br /> the issuance of this permit does not relieve me of compliance with other applicable codes and ordinances. <br /> -7151F 2- <br /> Applicant's Signature bate signed <br /> MUST BE COMPLETED BEFORE SUBMITTING TO DILHR: <br /> [3 Town 0 Village ❑ City of: Oakland <br /> :z X <br /> M <br /> UNICIPALITY # 0 7 - 0 2 0 None <br /> PERMITISSM <br /> 0 BYE Zoning Office OATS tSt&UED:; <br /> 6/25/92 <br /> SBD 8254(N 09/89) White-Issuing Jurisdiction Pink-DILHR Within 30 Days Yellow-Applicant <br />