HomeMy WebLinkAbout0117508-Plumbing (water service relay)
0
OSHKOSH
ON THE WATER
Job Address 1249ELMWOODAVE
Contractor FREUND EXCAVATING
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner LARRY A BOOSrrAMMY L POTIER
Category 401 - Residential-Exterior (laterals)
Bathtub --2 Shower --2 Water Softner --2 Wait St.
Whirlpool --2 Floor Drain 0 Local Waste --2 Ice Chest
Lavatory 0 Lndry Tray --2 Clothes Wshr --2 Exam Sink
Toilet --2 Disposal 0 Bidet 0 Sculry Sink
Res. Sink 0 Dishwasher --2 BeerTap --2 Hand Sink
Bar Sink 0 Sump Pump 0 Lab Sink 0 Plaster Sink
Water Heater 0 Classrm Sink 0 Sterilizer 0 Surgeons Sink
Site Drain --2 Breakrm Sink 0 DipWell 0 F Prep Sink
Roof Drain 0 Ejector/Grind 0 Drink Ftn 0 Serv Sink
Misc. 0
Fixtures
0 Shamp Sink --2
0 Flr/Wst Sink 0
0 Catch Basin 0
0 Wash Ftn 0
0 Urinal 0
0 Standp Rec 0
0 Ice Maker --2
0 Gar Drain --2
0 Soda Disp 0
No
117508
Create Date 12/06/2005
Plan
Coffee Maker 0
Int Grease Trap --2
Ext Grease Trap --2
RPZ Valve 0
Eye Wash Statn 0
Wtr Sewer Mtrs 0
Deduct Meters 0
Wtr Usage Mtrs 0
Use/Nature
ofWork
r"'"^~~"c' ,,~,
Size
Material
Sanitary Sewer
Storm Sewer
Water Service
Copper
1"
Type
# Conn. Type
0
0
0
0
0
0
0
0
0
0
Repair
Valuation
$1,500.00
$0.00
Permit Fees
Parcelld #
1201690000
Plan Approval
Lateral
$50.00 0 Permit Voided I
Issued By
Date 12/06/2005
In the performance of this work, I agree to perform 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 the work
described in this nnit application within an easement, the City strongly urges the pennit applicant to contact the
easement holde ( ) and to ~ecu any essary aR r vals before starting such activity.
Signature
Agent/Owner
OMRO
WI 54963 - 0000
Address 3135 DELHi RD
Telephone Number
Date J~-6 -¿;-5
920-685-2196
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.