HomeMy WebLinkAbout0124800-Plumbing (storm lateral)
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OSHKOSH
ON 'i~HE WATER
Job Address 2480 MINERVA ST
CITY OF OSHKOSH
No
124800
PLUMBING PERMIT - APPLICATION AND RECORD
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
Owner THERESA A RONSON 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
Install new 4" storm lateral.
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer 4" Plastic Lateral 1 New
Water Service
Parcelld #
1229540000
Valuation
$950.00 Plan Approval
$0.00 Permit Fees
$50.00 0 Permit Voided I
Issued By
Date 05/15/2007
Agent/Owner
OMRO
Date 5-j.? -07
Signature
Address 3135 DELHI RD
WI 54963 - 0000 Telephone Number 920-685-2196
To schedule inspections please call the Inspection Request line 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.
Citv of Oshkosh
Intpection Services Division
P'O Box 1130
'Oshkosh, WI 54903-1130
Phone: (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 ofwmch 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 $100.00 plus the
normal permit fee, which ever is greater.
OR
If YOU are a contractor participating in the Permit Fee Account System and have adequate funds. check here
if vou want this processed throuflh your account n
Job Address;;~ /Y11A1E~vlt 5T
Owner ,FRESH LO/jS/J/I/
J'ZlSingle Family DDuplex DMulti-Family
.Jf.
Value (Including labor and materials) '!5(J. ""
Contractor
Date5 -;5 -07
f,fttA.1II/J exCAt/NT/Jllt;
DRental
DCommercial
DIndustrial
Number of Fixtures:
Bathtub Disposal
Whirlpool Dishwasher
Lavatory Sump Pump
Toilet Ejector/Grind
Res. Sink Water Softner
Bar Sink Local Waste
Water Heater Clothes Wshr
o Gas 0 Elect 0 PwrVnt Bidet
Shower Beer Tap
Floor Drain Classrm Sink
Lndry Tray Surgeons Sink
Lab Sink Breakrm Sink
Plaster Sink Dip Well
Sterilizer Hose Bibs
Misc.
Fixtures
Electric Contractor OR
DrinkFtn Catch Basin
Wait. St. Wash Ftn
Ice Chest Urinal
Exam Sink Gar Drain
Sculry Sink Soda Disp
Hand Sink Coffee Maker
F Prep Sink Comm. Ice Maker
Serv Sink Site Drain
Int Grease Trap Roof Drain
Ext Grease Trap Standp Rec
RP.Z. Valve Eye Wash Stn
Shamp Sink Wtr Sewer Mtrs
FlrlWst Sink Deduct Meters
Wtr Usage Mtrs
DElectric Installation Verification form attached
(If Replacement)
Use / Nature of Work 5roltU jEt1IER llJrQIiL-
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
1/11
IIJf$Tlc
tllTER!IL
I
New
Water Service
11/05