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~ CITY OF OSHKOSH No 115736
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1622 EVANS ST Owner SUSAN L STINDT Create Date 08/11/2005
Contractor WATTERS PLUMBING Category 411 - Residential-Water Heaters Plan
Bathtub 0 Shower 0 WaterSoltner 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Whirlpool 0 Floor Drain 0 Local Waste 0 Ice Chest 0 FlrlWst Sink 0 Int Grease Trap 0
Lavatory 0 Lndry Tray 0 Clothes Wshr 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Toilet 0 Disposal 0 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Res. Sink 0 Dishwasher 0 BeerTap 0 Hand Sink 0 Urinal 0 Eye Wash Statn 0
Bar Sink 0 Sump Pump 0 Lab Sink 0 PlasterSink 0 Standp Rec 0 Wtr Sewer Mtrs 0
Water Heater 1 Classrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0 Deduct Meters 0
Site Drain 0 Breakrm Sink 0 Dip Well 0 F Prep Sink 0 Gar Drain 0 Wtr Usage Mtrs 0
Roof Drain 0 Ejector/Grind 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Misc. 0
Fixtures
Use/Nature
ofWork
Valuation
Issued By
Install replacement water heater (Debit Account)
Size Material Type # Conn. Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0 Parcelld #
0 1511090000
$695.00
$0.00
$20.00 0 Permit Voided I
Plan Approval
Permit Fees
Date 08111/2005
In the perfonmance of this work, I agree to perfonm all work pursuant to rules govemlng the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perfonm the work
described in this penmit application within an easement, the City stron9iy urges the penmit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Address PO BOX 118
Signature
Date
AgenUOWner
MENASHA
WI 54952 - 0118
Telephone Number 920-733-8125
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.