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Home My WebLink About0001291-Plumbing (laterals) ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 01291 lYP_E~ _ _ BL~G _~ _ HT~ [? _. ~~. EC.".~. _.. ~Ll. G_. ~ 7 _ ~ON~N~ _ _ _ _ _ _ _F~~D PLAI~ _ _ ._ _ _ _ H~'~~T _ _ _ _ ADDRESS /8/0 f9r.r; "- ~ PLAN NO. A<Le~ ,'-~~ 4M/~~~ OWNER ~ DESIGNER USE/NATURE OF WORK BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR Electric Servo New 0 Change 0 Temp 0 Type _ Volts _ Amps_ Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR Vti),YVI>..s;. ~<-{/-e~ _ BT _ WH _ Disp _ WSoft _ CBasin _WC _Sh _FDr _ L Tub _DW _SP _DF _ San. Sewer -f"C(rv( _Lav _Sink Other _ Eject _SS _ Storm Sewer _ Water / /( ~tf'fr--- _Ur ,....., v-:; t:r<9 FEES: Valuation $ .".,L- LJ 0 ./ Permit Fee Paid $ ISSUED BY ~.~ Date / /5~ v' ?./~/~ d! Park Dedication $ Final/O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE <---- ~ ~ ~ AGENT/OWNER DATE ADDRESS TELEPHONE #