HomeMy WebLinkAbout0042761-Plumbing (storm sewer)
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H2- - 42761
CITY OF OSHKOSH
PERMIT - APPLICATION AND RECORD
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ADDRESS Llri;::J ~~..d \1.;.tJY)
OWNER çÞ(IfJ) 'Î.U .ìfun m ,
PLAN NO.
DESIGNER
USE/NATURE OF WORK ~ )IY\<r\o. QQ ~'fm i.lYì 0(\ r lAO v\
BUILDING CONTRACTOR
Size Sq. Ft.
Foundation
# Rooms
# Stories
Height
Occupancy Permn
Class of Cons!.
-HEATING CONTRACTOR
Heat 0 AlC 0 Vent 0 Fuel/System
Heat Loss
. BTU'S
ELECTRIC CONTRACTOR
Electric Servo
Fixtures
New 0 Change 0 Temp 0
Type - Volts - Amps -
Switches
Receptacles
Circuits
PLUMBING CONTRACTOR 1) Q l1û.fì<;tn
_Lav
_WH
_Sh
_Disp
_DW
_WSoft
_DF
- CBasin
L
_BT
_WC
_FDr
_LTub
_SP
- Eject
_Ur
- San. Sewer
L Storm Sewer
_Water
Y:f~J C
_Sink
Other
_SS
ISSUED BY
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/ó.Oð'/
Permit Fee Paid $
Date ~57 - Y ¡¿-
102-1
Park Dedication $
FinaVO.P.
In the performa
rm all work pursuant to rules governing the described construction.
SIGNATURE
DATE
AGENT/OWNER
ADDRESS
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ÁDDlIESS
CJIlNElI.
NAwaE 01! \leu:
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DUE
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Sum Pu
Ejector
Water Softener
Drinkin Fountain
S10 Sink
rease Tra
Local Waste
Site Drain
Laundr Stand i e
Catch Basin