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OSHKOSH
ON THE WATER
Job Address 3190 OLD ORCHARD LN
CITY OF OSHKOSH
No
116411
PLUMBING PERMIT -APPLICATION AND RECORD
Owner MARK H/KRISTEN LASKY
Contractor D.R. HANSEN PLBG.
Category 410 - Residential-Interior
Create Date 09/08/2005
Plan
Coffee Maker 0
Int Grease Trap 0
Ext Grease Trap 0
RPZ Valve 0
Eye Wash Statn 0
Wtr Sewer Mtrs 0
Deduct Meters 0
Wtr Usage Mtrs 0
Bathtub 1 Shower 1 Water Softner 0 Wait.St. 0 Shamp Sink ----.2
Whirlpool 0 Floor Drain 0 Local Waste 0 Ice Chest 0 FlrlWst Sink 0
Lavatory 2 Lndry Tray 0 Clothes Wshr 0 Exem Sink 0 Catch Basin 0
Toilet 1 Disposal 0 Bidet 0 Scuiry Sink 0 Wash Ftn 0
Res, Sink 0 Dishwasher 0 BeerTap 0 Hand Sink 0 Urinal 0
Bar Sink 0 Sump Pump 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Water Heater 0 Classrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Site Drain 0 Breakrm Sink 0 Dip Well 0 F Prep Sink 0 Gar Drain ----.2
Roof Drain ----.2 Ejector/Grind 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Misc. 0
Fixtures
UselNature
of Work
Remodle and addition interior plumbing for bathrooms. (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 1417480000
Valuation
$3,000.00
Plan Approval
$0.00
Permit Fees
$35.00 0 Permit Voided I
Issued By
Date 09122/2005
In the perfonnance of this work, I agree to pertonn all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you pertonn the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement hoider(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Address 55 KNAPP ST
Agent/Owner
OSHKOSH
WI 54902 - 0000
Telephone Number 233-1595
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.