HomeMy WebLinkAbout0122880-Plumbing (sewer lateral)
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OSHKOSH
ON THE WATER
Job Address 838 BOWEN ST
Contractor MR ROOTER OF THE FOX VALLEY
CITY OF OSHKOSH No 122880
PLUMBING PERMIT - APPLICATION AND RECORD
Owner RICHARD E PAGEL LIVING TRUST Create Date 12/13/2006
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Category 401 - Residential-Exterior (laterals)
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Lab Sink
Sterilizer
Dip Well
Drink Ftn
Wait. St.
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
Plan
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Sleeve existing sanitary sewer to right of way. A solid, watertight connection shall be made where the existing lateral and sleeve meet. **debit
acet
Size Material Type # Conn. Type
Sanitary Sewer 4" Plastic Lateral 1 Relay
Storm Sewer
Water Service
Parcelld #
. 1106550000
Valuation
$2,500.00 Plan Approval
Issued By
n'n ~():OO Permit Fees
$50.00 0 Permit Voided I
Date 12/13/2006
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
Date
Agent/Owner
Address PO BOX 3063 no ,ll,F>PLETON WI 54914 - 0000 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 (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.
~ 12/13/2006 12:14
~ City of Oshkosh
-=- Inspection Services Division
P 0 nox 1130
(' Oshkosh, WI 54903.1130
.. , PhoDe~ (920) 236-5050
Fu: (920) 236--5084
'320687'3407
MR ROOTER
PAGE 01
ce.
~Q(8
Plumbing Pennit Application
I heteby apply for a permit to do andiostaU the foUowing plumbing em the pa;mises hereinaftr:r deacribed, ~ ~ to ~ to the
Wiscousin Slate PluInbibg ~ in the pcdn..IUitOCe ofwhich aU"puties hereto agree toamd lie bound by Aid Sfafutea.
· Application(s) and fee(s) can be brought toCityHa1I, Room 205 or mailed to InspeCtion Services, PO Box 1118,
Oshkosh WI 54903-1128. Commencing work: without pcnnit(s) will result in fees being doubled or $100.00 plus the .
normal permit fee, which ever is greater.
OR
~::: '::all.: ~~:tract:; ~arti;il1ati7l:C ~ tll~ P:;1IJi~el!. Acc~unt System and./lave: ~de(1uate Funds. clleck lH:r~.
11 t Droc; d ill. Duell () ~ a co t . _'0: .... . .
--:'JobAddress ~S<6 Bow~ 'VaIDe(lnd~tla~mhna8!rials} ?5\lY)~c).:...' :'Date l/fJ IC7
.
Owner 12l~ Pa~i1~ Contractor KtL lZotYTEe. RA,iA.~~.h,'':j
~Single Family' . Onuplex-. DMultl~Famlly.: [JReutal DComm~[claJ.' ~. [JI1id.ustri,r: ;'J~:: . ~, .'
r", Number of FIxtUres:
. .8atbrub
~irfpOoI
Lavatory
~;':,~.~-:' :\f :..< ~.;i~'r:;;~
T oilc'
Res. Sink
Disposal .
DishWlliMr
Sump~
r::.teclDdGrind
Wa_ Sotblcr
Load WlI$te
CIotlu:I WJbr
Bidet
Bca!r Tap
Clusrm SiDle
&qeons Siuk
8reaknn Sink
Dip Woll
Hose Bib/:
DrInk Ftn
Wait.St.
Ice Chest
Exam Sink
Scuby Sink
lland Sink
F Pn:p SQ.1c:
~Sink
lilt ar- inp
Bxc Greue Tmp
1t..P.z. VIM
S~ Sink
FlrlWlIlt Sink
. .:; '. CalI:h Basin
. Wadi PIn
UtilUll
a.r Drain
~
Bar Sh\k
WatGr Healer
o GlIS 0 IiICct 0 I'wrVnt
Shower
Floor ~n
Lncky Tray'
):..ab Sink
Plaslcr Sink
Su:riIi2er
.SodI I>iBp
Coffee Mabt
Cormn. lee Maker
Site DrAin
RoofDraln
s~&c
Bye Wash SI1'l
Wtr~ MU'5
Deduct Meters
Wtr Usage Mtrs
Misc.
FilltUtc$
Eledric Contractor
QB.
[]Electric InstaUatiOD Verification form attached
(If Replacement)
S+r.ed-
Use/Nature of Work
~/e~ ~ f?Jl. .-fz>
Size
Material
Type
#
CoDD. Type
Sanitary Sewer
Storm Sewer
Water Service
'- @ 1'/0"