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G CITY OF OSHKOSH No 117030
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 450WMURDOCKAVE Owner XIU LI YANG Create Date 10/31/2005
Contractor MR ROOTER OF THE FOX VALLEY Category 440 - Industrial-Interior Plan
Bathtub 0 Shower 0 Water Softner 0 Wai!.S!. 0 Shamp Sink ---.!! Coffee Maker 0
Whirlpool 0 Floor Drain ---.!! Local Waste ---.!! 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 ---.!! Disposal 0 Bidet ---.!! Sculry Sink 0 Wash Ftn 0 RPZ Valve 0
Res. Sink 0 Dishwasher 0 Beer Tap ---.!! Hand Sink ---.!! Urinal 0 Eye Wash Statn ---.!!
Bar Sink 0 Sump Pump 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0
Water Heater ---.!! Classrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0 Deduct Meters ---.!!
Site Drain 0 Breakrm Sink 0 DipWell 0 F Prep Sink 0 Gar Drain 0 Wtr Usage Mtrs 0
Roof Drain 0 Ejector/Grind 0 Drink Ftn ---.!! Serv Sink ---.!! Soda Disp 0
Misc. 0
Fixtures
Use/Nature
ofWork
Repair sanitary sewer and building drain. correct grease trap cover seal and remove obstruction from building drain.
Sanitary Sewer
Size
4"
Material
Plastic
Type # Conn. Type
Lateral 1 Repair
0
0
0
0
0
0
0
0
0
0
0
0
0
0
$50.00 0 Permit Voided I
Parcelld #
1219260100
Stonn Sewer
Water Service
Valuation ~3,000.00
Issued By ~
Plan Approval
$0.00
Permit Fees
Date 10/31/2005
In the performance of this work, I agree to perfonn 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 perform tI1e work
described in this pennit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Address PO BOX 3063
AgenVOwner
APPLETON
WI 54914 - 0000
Telephone Number 920-687-9178
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.