Laserfiche WebLink
4156 Charleston Exec. <br /> Wisconsm Department of Industry, WISCONSIN UNIFORM BUILDING Application No <br /> Labor and Human Relations PERMIT APPLICATION <br /> Safety and Buildings Division <br /> P 0 Box 7969 (See instructions on back of pink copy) Parcel No. <br /> Madison,WI 53707 The information you provide may e used by other government agency <br /> i <br /> Wisconsin Statutes 101 63. 101 73 programs'Privacy Laws 15 04(11)(m)I <br /> PERMIT REQUESTED ®Constr HVAC El Elec NPlbg ER Erosion El Other: <br /> Owner's Name !Mailing ddress Telephone No <br /> MIDLAND BUILDERS , INC . 6709 Raymond Rd. , Madison, WI 53719 ( 271-4444 <br /> Contractor's Name: ❑Con ❑Elec KHVAC ❑Plbg Lic/Cert# Mailing Address Telephone No I <br /> Midland Heating Co . H10177 6703 Raymond Rd. , Madison 53719 ( ) 271-4444 <br /> Contractor's Name. ❑Con ❑Elec ❑HVAC KPlbg Lrc/Cert# Mailing Address Telephone No <br /> Benjamin Plumbing 3447 5396 King James Way, Mad.53719 ( ) 271-7071 <br /> Contractor's Name ❑Con XIElec ❑HVAC ❑Plbg Lic/Cert# Mailing Address Telephone No <br /> Hill Electric Co. 10124 1044 S . Park St . , Madison 53715 ( ) 256-2983 <br /> Contractor's Name: XLCon ❑Elec ❑HVAC ❑Plbg Lic/Cert# Mailing Address Telephone No <br /> MidlgtJd Buiclde;s , Inc . 6709 Raymond Rd. . Madison 53719 ( ) 271-4444. <br /> PROJECT LOCATION L 2 7r, 1 6 6 Sq ft 1/4, 1/4,Section T N,R E(or)W <br /> Building Address Subdivision Name of Lot No. Block No. <br /> 8514 Stonebrook Circle Stonebrook Estates '0 5 <br /> District(s) Zoning Permit No. Front Rear Left Right <br /> Zoning D1 �R��, Setbacks 51 ft l 113 ft 32 ft 27 ft <br /> 9 <br /> 1,'PROtECT <br /> '3 .OCCEIPmC.Y.. .6 :ELEC'i.Roki. 9. I.11tACEt?UIpMEN't <t2,; ENERGY:SIIO. . <br /> XNew ❑Repair FISingle Family Entrance Panel ft.Forced Air Furnace Nat L P Oil Elec Solid Solar <br /> ❑Alteration ❑Raze ❑Two Family Size:_2 00 amp ❑Radiant Baseboard or Panel Fuel Gas <br /> ❑Addition ❑Move ❑Garage Service: ❑Heat Pum <br /> ❑Other(print): ®Underground ❑Boiler Pump Space Htg ❑ ❑ ❑ ❑ ❑ <br /> ❑Overhead jAi Central Air Conditioning Water Htg ,W ❑ ❑ ❑ ❑ ❑ <br /> ❑Other <br /> 4. C©NST, � �� FOUNDATION ❑Other *❑Dwelling unit will have 3 kilowatt or <br /> �S�te Constructed Concrete more installed electric space heating equip <br /> 1 ❑Manufactured ❑Masonry PLUIU1BING,• Infiltration control option is ❑Full sealing <br /> 2,'ARI :INVOI, EA' ❑Treated Wood Sewer of Joints ❑Blower door test ❑Exterior <br /> air infiltration barrier <br /> Unfinished Basement 12 3 lq ft S. STQRIES ❑Other ❑Municipal <br /> 267068 <br /> -- Li t Story R. USE (Septic '3 •;HEAT LOSS {Calculated) <br /> Levin Area Permit No 96-0439 Living 22O�q ft Envelope 29 ,1$9 BTU/HR <br /> ®2-Story ❑Seasonal 17,227 BTU/HR <br /> Garage 46;q ft ❑Other ®Permanent ' Infiltration <br /> 9 <br /> ❑Other ❑Municipal Utility 4 ESrT:.)L8LDINGcOS'# <br /> Total 3899 ❑Plus Basement X Private On-Site Well $ 167 ,000 <br /> The applicant agrees to comply with all applicable codes,statutes and ordinances and with the conditions of this permit, understands that the issuance of <br /> the permit creates no legal liability,express or implied,on the Department or municipality;and certifies that all the above information is accurate <br /> APPLICANT'S SIGNATURE DATE SIGNED <br /> APPROVAL CONDITIONS This permit is issued pursuant to the following conditions Failure to comply may result in suspension or <br /> revocation of this permit or other penalty <br /> ISSUING ❑Town ❑Village ❑City ❑County ❑State of Municipality Number of Dwelling Location: <br /> JURISDICTION <br /> • <br /> FEES: PEPIVI ) W1S.<:INIFORM PERi1M7` PERNiT ISSU ED BY: . <br /> ISSUED' SEAL Nth. <br /> Plan Review $ ❑Construction '' <br /> Inspection $ ❑HVAC Name <br /> Wis Permit Seal $ ❑Electrical <br /> Other $ ❑Plumbing Date <br /> ❑Erosion <br /> Total $ ❑ Cert.No <br /> SBD-5823(R 06/94) WHITE-Issuing Jurisdiction YELLOW-DILHR GREEN-Inspector PINK-Owner/Agent <br />