HomeMy WebLinkAbout0117190-Plumbing (water service)
e CITY OF OSHKOSH No 117190
OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD
ON THE WATER
Job Address 634 GRAND ST Owner ROSINA C LUCKOW Create Date 11/08/2005
Contractor D.R. HANSEN PLBG. Category 401 - Residential-Exterior (laterals) Plan
Bathtub 0 Shower 0 Water Softner 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 ~
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 Plaster Sink 0 Standp Rec 0 Wtr Sewer Mtrs 0
Water Heater 0 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
of Work
Relay water service from stop box to building (Debit Account)
Size Material Type # Conn. Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 1" Copper Lateral 1 Relay
0
0
0 Parcelld #
0 0405350000
Valuation
$1,500.00
Plan Approval
$0.00
Permit Fees
$50.00 0 Pennit Voided I
Issued By
Date 11/08/2005
In the performance of this work, I agree to perform all work pursuant to rules goveming the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perfonn the work
described In this permit application within an easement, the City strongly urges the pennit applicant to contact the
easement holder(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.