THIS IS NOT AN ACTUAL PERMIT. PERMIT WILL BE ISSUED BY TOWN OF SCHLEY AFTER REVIEW PROCESS
JURISDICTION : Town of SCHLEY
PROJECT TYPE : New
PERMITS : Construction
PARCEL NUMBER : 02232070149997
NAME : Vernell L Marschall
ADDRESS N4605 Wyant Ave, Merrill, 54452
CONTACT (715) 803-8735, vernmarschall@gmail.com
DWELLING CONTRACTOR
NAME :
LIC/CERT # : EXP DATE :
ADDRESS , ,
CONTACT ,
HVAC CONTRACTOR/QUALIFIER
ELECTRICAL CONTRACTOR
ELECTRICAL MASTER ELECTRICIAN
ADDRESS N4646, Merrill, 54452
AREA43400.00 SQ. FT.
1 OR MORE ACRES SOIL WILL BE DISTURBED false
LOCATION : Town of SCHLEY
BUILDING
ADDRESS : N4605 Wyant , Merrill, 54452
COUNTY Lincoln SUBDIVISON LOT NO. BLOCK NO.
ZONING
DISTRICT : PERMIT NUMBER :
SETBACKS Front ft.: Rear ft.: Left Ft.:Right ft.:
1. PROJECT TYPE : New
2. AREA :
AREA INVOLVED (SQ FT)
Unit 1
Unit 2
Total
3. OCCUPANCY : One Family
4. CONSTRUCTION TYPE :Site Built
5. STORIES :1-Story
6. ELECTRIC : Entrance Panel Amps 200, Underground
7. WALLS :Wood Frame
8. USE : Permanent
9. HVAC EQUIP : Other
10. SEWER :Sanitary Permit , TBD
11. WATER :On-Site Well
12. ENERGY SOURCE :
13. HEAT LOSS :
14. EST. BUILDING COST w/o LAND :95000.00
I understand that I: am subject to all applicable codes, laws, statutes and ordinances, including those described on the reverse side of the last ply of this form; am subject to any conditions of this permit; understand that the issuance of this permit creates no legal liability, express or implied, on the state or municipality; and certify that all the above information is accurate. If one acre or more of soil will be disturbed, I understand that this project is subject to ch. NR 151 regarding additional erosion control and stormwater management and the owner shall sign the statement on the back of the permit if not signing below. I expressly grant the building inspector, or the inspector''s authorized agent, permission to enter the premises for which this permit is sought at all reasonable hours and for any proper purpose to inspect the work which is being done.
I vouch that I am or will be an owner-occupant of this dwelling for which I am applying for an erosion control or construction permit without a Dwelling Contractor Certification and have read the cautionary statement regarding contractor responsibility on the reverse side of the last ply of this form.
SIGN/PRINT NAME:
DATE 10/13/2021 1:30 PM