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e
OSHKOSH
ON THE WATER
Job Address 1822 MOUNT VERNON ST
CITY OF OSHKOSH
No
117771
PLUMBING PERMIT - APPLICATION AND RECORD
Owner LINDA K SCHROTTKY
Create Date Ó1/05/2006
Contractor SAMMONS PLUMBING
Category 411 - Residential-Water Heaters
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 0 Disposal 0 Bidet 0 Seulry 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 Ree 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 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 I"'~"W" -"'IT~
of Work
Size
Material
Conn. Type
Type
#
0
0
0
0
0
0
0
0
0
0
Sanitary Sewer
Storm Sewer
Water Service
Pareelld #
1503310000
$20.00 0 Permit Voided I
Valuation
$600.00
Plan Approval
$0.00
Permit Fees
Issued By
Date 01/05/2005
In tI1e 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 tI1ls permit application witl1ln an easement, tI1e 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 522 W. MURDOCK AVE
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.