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OSHKOSH
ON THE WATER
Job Address 1009 S MAIN ST
CITY OF OSHKOSH
No
117763
PLUMBING PERMIT - APPLICATION AND RECORD
Owner AUTOMATIC CANTEEN CO
Create Date 01/05/2006
Contractor SAMMONS PLUMBING
Category 441 - Industrial-Water Heaters
Plan
Bathtub 0 Shower 0 WaterSoftner 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 Ex! 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 Piaster Sink 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 DipWell 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
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Size
Material
Type
#
0
0
0
0
0
0
0
0
0
0
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
0302490000
Valuation
$600.00
Plan Approval
$0.00
Permit Fees
$20.00 D Pennit Voided I
Issued By
Date 01/05/2006
In the performance of this work. I agree to perform ail work pursuant to ruies 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 permit application within an easement, the City stron91y urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature
Date
Address 522W.MURDOCKAVE
AgenUOwner
OSHKOSH
Wi 54901 - 2298
Telephone Number 231-9880
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.