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OSHKOSH
ON THE WATER
Job Address 641 EVANS ST
CITY OF OSHKOSH
No
124056
PLUMBING-PERMIT -APPLICATION AND RECORD
Owner STEVEN C MOEN
Create Date 04/03/2007
F Ian
Contractor SAMMONS PLUMBING
Category 411 - Residential-Water Heaters
Bathtub Shower Water Softner Wait. St. Shamp Sink Coffee Maker
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Whirlpool Floor Drain Local Waste - Ice Chest FlrlWst Sink Int Grease Trap
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Lavatory Lndry Tray Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
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Toilet Disposal Bidet - Sculry Sink Wash Ftn RPZ Valve
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Res. Sink Dishwasher Beer Tap Hand Sink Urinal Eye Wash Statn
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Bar Sink Sump Pump Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
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Water Heater 1 Classrm Sink Sterilizer Surgeons Sink Ice Maker Deduct Meters
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Site Drain Breakrm Sink Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
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Roof Drain Ejector/Gri nd Drink Ftn Serv Sink Soda Disp
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Misc.
Fixtures -
Use/Nature SFR / Replace gas water heater. ..DEBIT ACCT"".
of Work
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcelld #
1102610000
Valuation
$600.00 Plan Approval
$0.00 Permit Fees
$25.00 0 Permit Voided
Issued By
Date 04/03/2007
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 w rk
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 522 W. MURDOCK AVE
OSHKOSH
WI 54901 - 2298 Telephone Number 231-9880
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Per nit 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 n ceived. Work may
continue if the inspection is not performed within two business days from the time the project is rea y.
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