HomeMy WebLinkAbout0124798-Plumbing (storm lateral)
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OSHKOSH
ON THE WATER
Job Adcf~ess 1570 MARICOPA DR
CITY OF OSHKOSH
No
124798
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner MICHAEL MUSSEN Create Date 05/15/2007
Category 401 - Residential-Exterior (laterals) Plan
Water Softner Wait. St. Shamp Sink Coffee Maker
Local Waste Ice Chest FlrlWst Sink Int Grease Trap
Clothes Wshr Exam Sink Catch Basin Ext Grease Trap
Bidet Sculry Sink Wash Ftn RPZ Valve
Beer Tap Hand Sink. Urinal Eye Wash Statn
Lab Sink Plaster Sink Standp Rec Wtr Sewer Mtrs
Sterilizer Surgeons Sink Ice Maker Deduct Meters
Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Drink Ftn Serv Sink Soda Disp
Contractor FREUND EXCAVATING
Bathtub
Whirlpool
Lava1tory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valllation
Issued By
Install new 6" storm lateral ffor sump and roof drainage.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer 6" Plastic Lateral 1 New
Water Service
Parcelld #
1319890000
$2,600.00 Plan Approval
$0.00 Permit Fees
$50.00 D Permit Voided I
Date 05/15/2007
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 thO ermit application wi in an easem t, the City strongly urges the permit applicant to contact the
easement hold () and to seeure y ecessary ap ovals before starting such activity.
Signature
6 "/5 ;o~
Date
Agent/Owner
OMRO
WI 54963 - 0000 Telephone Number 920-685-2196
Address 3135 DELHI RD
To schedule inspections please call the Inspection Requesfline 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.
City of Oshkosh
Inspection Services Division
PO B'ox 1130
Oshkosh, WI 54903-1130
Ph.9ne: (920) 236-5050
Fax; (920) 236-5084
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~
OfHKOfH
ON THE WATER
Plumbing Permit Application
I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described, the work to conform to the
Wisconsin State Plumbing Code, 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) win result in fees being doubled or $100.00 plus the
normal permit fee, which ever is greater.
OR
If vou are a contractor participatinz in the Permit Fee Account Svstem and have adequate funds, check here
ifvou want this processed throuzh vour account n
Job Address /570 /1)#11 (Jt;M
Owner !hiKE H1l/5Sff1fl
~Single Family DDuplex
it
Value (Inc1uding labor and materials) ~, 1/1) Date 5-/5-0 7
f'JI e tll/ltJ Be,f 1I!frJ //16
Contractor
DMulti-Family
DRental
DCommercial
Dlndustrial
Number of Fixtures:
Surgeons Sink
Breakrm Sink
Dip Well
Hose 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
R.P .Z. Valve Eye Wash Stn
Shamp Sink Wtr Sewer Mtrs
FlrIWst Sink Deduct Meters
Wtr Usage Mtrs
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
o Gas 0 Elect 0 PwrVnt
Shower
Floor Drain
Lndry Tray
Lab Sink
Plaster Sink
Sterilizer
Misc.
Fixtures
Disposal
Dishwasher
Sump Pump
Ej ector/Grind
Water Softner
Local Waste
Clothes Wshr
Bidet
Beer Tap
Classrrn Sink
OR DElectric Installation Verification form attached
(If Replacement)
Electric Contractor
Use I Nature of Work 5101. m
:5E wttf tATE ,(If L
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
6 "
fLIIs TIC
iJ1 rEI<#- I
-
Ale ())
Water Service
n/05