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OSHKOSH
ON THE WATER
Job Address 931W12THAVE
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner STEVEN C CROOKS
Contractor MR ROOTER OF THE FOX VALLEY
Category 410 - Residential-Interior
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
1 Classrm Sink
Breakrm Sink
Ejector/Grind
WaterSoftner
Local Waste
Clothes Wshr
Wail.SI.
Ice Chest
Exam Sink
Sculry Sink
Hand Sink
Plaster Sink
Surgeons Sink
F Prep Sink
Serv Sink
Shamp Sink -
FlrlWst Sink
Catch Basin
Wash Ftn
Urinal
Standp Rec
Ice Maker
Gar Drain
Soda Disp
No
Bidet
Beer Tap
Lab Sink
Sterilizer
Dip Well
Drink Ftn
Create Date
Plan
Coffee Maker
Int Grease Trap
Ext Grease Trap -
RPZValve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
REPLACE GAS WATER HEATER "OEBIT ACCT
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Pareelld #
1306470000
Use/Nature
ofWork
Valuation
Issued By
$700.00
Plan Approval
$0.00
Permit Fees
$20.00 0 Permit Voided I
Date 05/09/2006
In the performance of this work, I agree to perform all work pursuant to rules goveming 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 strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvais before starting such activity.
Signature
Address PO BOX 3063
AgenUOwner
APPLETON
WI 54914 - 0000
Date
Telephone Number 920-687-9178
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.