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OSHKOSH
ON THE WATER
Job Address 209 MASON ST
CITY OF OSHKOSH
No
117778
PLUMBING PERMIT - APPLICATION AND RECORD
Owner ELAINE M MILLER LIFE ESTATE
Create Date 01/05/2006
Contractor SAMMONS PLUMBING
Category 410 - Residential-Interior
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 0
Toilet 1 Disposal 0 Bidet 0 Sculry Sink 0 Wash Ftn 0 RPZValve 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
RoolDrain 0 Ejector/Grind 0 Drink Ftn 0 Serv Sink 0 Soda Disp 0
Misc. 0
Fixtures
Use/Nature I~'~"~mm- œm ~cr
01 Work
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Valuation
$350.00
Plan Approval
$0.00
Permit Fees
0
0
0
0
0
$20.00 0 Permit Voided I
Parcelld #
0610170000
Issued By
Date 01/05/2006
In the performance 01 this work, I agree to perfonm 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 perfonm the work
described in this permit 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 522W.MURDOCKAVE
Agent/Owner
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.