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0
OSHKOSH
ON THE WATER
Job Address 1930 SIMPSON ST
Contractor J RASMUSSEN PLUMBING INC
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
ofWork
Valuation
Issued By
CITY OF OSHKOSH
No
119385
PLUMBING PERMIT. APPLICATION AND RECORD
Shower
Floor Drain
0 Lndry Tray
1 Disposal
Dishwasher
Owner LUCILLE E MILLER Create Date 05/08/2006
Category 410 - Residential-Interior Plan
Water Softner Wait St. Shamp Sink - Coffee Maker
Local Waste Ice Chest FlrlWst Sink Int Grease Trap
Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
- -
Bidet Sculry Sink Wash Ftn RPZ Valve
Beer Tap Hand Sink Urinal Eye Wash Statn
Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Sterilizer Surgeons Sink Ice Maker Deduct Meters
Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Drink Ftn Serv Sink Soda Disp
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
r~~'"' ~"'OO~ -"'IT ~
Size
1#
Conn. Type
Material
Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld 1#
1409700000
$150.00
$0.00
$20.00 0 Permit Voided I
Plan Approval
Permit Fees
Date 05/0812006
in the performance of this work. I agree to perform all work pursuant to nules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which itis not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement hoider(s) and to secure any necessary approvals before starting such activity.
Signature
Address 1914 GREENBRIAR TRL
Date
AgenUOwner
OSHKOSH
WI 54904 - 0000
Telephone Number 920-233-6747
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.