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OSHKOSH
ON THE WATER
Job Address 126 W CUSTER AVE
CITY OF OSHKOSH
No
126170
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner RICHARD A WARRICK JR Create Date 08/08/2007
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 Scurry 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 D.R. HANSEN PLBG.
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
Cap clay sewer and lead water laterals for raze of structure.***Debit Account
Size Material Type # Conn. Type
Sanitary Sewer 6" Vitrified Clay Lateral 1 Aband
Storm Sewer
Water Service 3/4" Lateral 1 Aband
Parcelld #
1501010000
$300.00
$0.00
$25.00 D Permit Voided I
Plan Approval
Permit Fees
Date 08/08/2007
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 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
OSHKOSH
Address 55 KNAPP ST
WI 54902 - 3448 Telephone Number 233-1595
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.
City of Oshkosh Engineering Dept. Street
Location of Sanitary - Storm - Water Laterals W Custer Ave
~ Abandonment D New Installation
Address: 126 W Custer Ave. 8/8/07 By: D. R. Hansen Plumbing
.
~ Material Size Depth Location
Sanitary Clay 6in 4ft 14 feet E of W Property Line
Storm
Water Lead 3/4 in 4 1/2 ft 14 feet E of W Property Line
Property File Copy
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