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0098653 P
OSHKOSH ON THE WATER Job Address 515 W 18TH AVE Contractor NOVAK EXCAVATING INC Bathtub Whirlpool Lavatory Toilet Res. Sink Bar Sink Water Heater Site Drain Roof Drain CITY OF OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD Owner GLENN/BONNIE GRIGGERS Category 401 - Residential-ExteriOr (laterals) 0 Shower 0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 0 Floor Drain 0 Water Softner 0 Drink Ftn 0 Serv Sink 0 0 LndryTray 0 Local Waste 0 Wait. St. 0 ShampSink 0 0 LndryStndp 0 CIothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 0 Disposal 0 Bidet 0 Exam Sink 0 Catch Basin 0 0 Dishwasher 0 BeerTap 0 SculrySink 0 Wash Ftn 0 0 Sump Pump 0 Dent. Oper. 0 Hand Sink 0 Urinal , 0 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0 No 98653 Create Date 11/15/2002 Plan Gar Drain Soda Disp Coffee Maker Int Grease Trap Ext Grease Trap __ Use/Nature of Work NSFR Sanitary Sewer Storm Sewer Water Service 1 Size Material Type # 4 Plastic Lateral Copper Lateral Conn. Type 0 0 1 New 0 0 0 0 0 0 0 0 0 I New 0 0 Valuation $2,000.00 Plan Approval $0.00 Permit Fees $50.00 Issued By Date 11/15/2002 [] Permit Voided J In the performance of this wor.k, I agree to peCc)rm all/~rk pursuant to rules governing the described construction. Signature ///~ ,,//~ ~'//~ Date yy- ~,~ - ' Agent/Owner Address PO BOX389 RIPON WI 54971 - 0000 Telephone Number 920-748-2512 OR 57