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OSHKOSH
ON THE WATER
Job Address 2550 VILLAGE LN
PLUMBING PERMIT - APPLICATION AND RECORD
CITY OF OSHKOSH No 122800
Owner BETTY LOU CARTER Create Date 12/05/2006
Plan
Category 411 - Residential-Water Heaters
Contractor MERTEN PLUMBING
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest FlrlWst Sink
Lndry Tray Clothes Wshr Exam Sink Catch Basin
Disposal Bidet Sculry Sink Wash Ftn
Dishwasher Beer Tap Hand Sink Urinal
Sump Pump Lab Sink Plaster Sink Standp Rec
Classrm Sink Sterilizer Surgeons Sink Ice Maker
Breakrm Sink Dip Well F Prep Sink Gar Drain
Ejector/Grind Drink Ftn Serv Sink Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
SFR (CONDO UNIT) /INSTALL GAS WATER HEATER
Size Material .. Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1320511600
Valuation
Issued By
$810.00 Plan Approval
'8Yn~,-,)
$0.00
$25.00 0 Permit Voided I
Date 12/05/2006
Permit Fees
In the 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 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
Address 1076 COZY LN
Agent/Owner
OSHKOSH
WI 54901 - 0000 Telephone Number 231-6795
Date
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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.
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City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920)236-5050
Fax: (920)236-5084
DEe 0 5 2006 2
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C:-" --i;: \VATFR
Plumbing Permit Application
I hereby apply for a permit to 00 and install the following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plumbing C<:lOt>.. in the performance of which all parties hereto agree to and are bound by said statutes.
· Application(s) and fee(s} can be brought to City Hall, Room 205 or mailed to Inspection Services, PO Box 1128.
Oshkosh WI 54903-1128_ Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
normal permit fee, which. ever is greater.
OR
Ifvou are a contractor participajing in the Permit Fee Accollnt Svstem and hare adequate funds. check here
if VOll want this processed ,hrough vour account n
Job Address ~ fl. V~
Owner J.) LY 1\/
~Single Family []Du.plex
Value (Including labor and materialS)--.-!' 10. co Date 1 f /:2 ~ I 0 ~
rV\.Q1~_b~ / p lu~~
DRental DCommercial Dlndustrial
Contractor
DMulti-FamiIy
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater I
w..Gas 0 Elect 0 PwrVnt
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
Disposal
Dishwashe'C
Smnp PIm:Ip
~
Water Scftner
Ux:aI W:asre
Oothes Wshr
Bidet
Beer Tap
Oassrm Sink
SmgeonsSink
Breakrm.Sink
DipWeI.i
I100e Bibs
DrinkFtn Catch Basin
Wait St Wash Ftn
Ice Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink Comm. Ice Maker
Serv Sink Site Drain
Int Grease Trap Roof Drain
Ext Grease Trap Standp Rec
RP.Z. Valve Eye Wash Stn
SharnpSink Wtr Sewer Mtrs
FlrlWst Sink Deduct Meters
Wtr Usage Mtrs
Fixtures
Electric Contractor
OR
DElectric Installation Verification form attached
{If Replacement)
Use / Nature ofWork__.
Size
-
Material
Conn. Type
Type
#
Sanitary Sewer
Storm Sewer
Water Service
11/05