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OSHKOSH
ON THE WATER
Job Address 2432 HICKORY LN
CITY OF OSHKOSH
No 91333
PLUMBING PERMIT - APPLICATION AND RECORD
Owner ARTHUR W & CECILIA BAIER
Create Date 11/07/2001
Contractor SAMMONS PLUMBING
Category 410 - Residential-Interior
Plan
Bathtub Shower 1 Ejector/Grind Dip Well F Prep Sink
Whirlpool Floor Drain 1 Water Softner Drink Ftn Serv Sink
Lavatory Lndry Tray Local Waste Wait. St. Shamp Sink
Toilet Lndry Stndp Clothes Wshr Ice Chest FlrlWst Sink
Res. Sink Disposal Bidet Exam Sink Catch Basin
Bar Sink Dishwasher Beer Tap Sculry Sink Wash Ftn
Water Heater Sump Pump Dent. Oper. Hand Sink Urinal
Site Drain Classrm Sink Lab Sink Plaster Sink Standp Rec
Roof Drain Breakrm Sink Sterilizer Surgeons Sink Ice Maker
Use/Nature
of Work
CONNECT TO CITY SEW & WTR
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Size
Material
Type
#
Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Valuation
$4,000.00
Plan Approval
$0.00
Permit Fees
$30.00
Issued By
Date 11/15/2001
D Permit Voided I
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Address 522 W. MURDOCK AVE
Agent/Owner
OSHKOSH
WI 54901 - 2298
Telephone Number 414-231-9880