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OSHKOSH
ON THE WATER
Job Address 40 E WAUKAU AVE
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CITY OF OSHKOSH
126296
No
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner MARC H OL TRA Create Date 08/16/2007
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
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
Valuation
Issued By
Repair sanitary sewer.
Size Material Type # Conn. Type
Sanitary Sewer 4" Plastic Lateral 1 Repair
Storm Sewer
Water Service
Parcel Id #
1417140000
$800.00
Plan Approval
$0.00
$50.00 0 Permit Voided I
Permit Fees
Date 08/16/2007
I n 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
OMRO
WI 54963 - 9724 Telephone Number 920-685-2196
Address 3135 DELHI RD
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. 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.
Ig 16 0'7 06:24a
fu~~;ti;;'s;~ices Division
POBox 1130
Oshkosb, WI 54903-1130
Phone: (920)236-5050
Fax: (920) 236-5084
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OJHKOJH
ON THE ''''ATE R
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 C.ity 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. .
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** Advisory _ For applicable projects, an Electrical I:nsta11ation Verification (EIV) 'form, signed by the Electrlcal
Contractor or Homeowner (for iDsta1latioDS allowed to be perfonned by the homeownex) must be submitted
with the pennit application. Applications submitted without an EIV when sv.ch is required, will not be
_ processed for pexmifIssuance and will be retmned for completion.
Job Address 40 E. WAUKAU A VB. Value (Including labor and materiall;) $800.00 Date 8-16-07
Owner MAR.K OHRA . Contractor FREUND EXCAVATING
[XJSingle Family ODuplex []Multi-Family ORental DCommereial DIndustrial
Number of Fixtures:
Bathtub Disposal DrillkFtn Catch Basin
Whirlpool Disbwasber Wait. St. WashFm
LavaroJY Sump Pump - Ice Chest Urinal
Toilet EjectOtfGrind Eum Sink. Gar Drain
Res. Sink Water Soflncr Sculry Sink Soda Disp
Bar Sink Local Wallie HaI1d Sink Coffi:e Maker
Water Heater - Clolhcs Wsbr F Prep 5rot Comm. lee Maker
o Gas 0 Elect iJ PwrVllt Bidet Sen-Sink Site Drain
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Sbower BcerTap Int Grease Trap ROClfnmio
Floor Drain Classrm Sink. 'Ext Grease Trap Sbtl'ldp Rec
Lndry Tray S1Jrgeoos Sink R.PZ. Valve Eye Wash St1i.
Lab Sink: BrCllkrm Sin"k Shamp Sink Wtr Sewer MIrS
PlastcrSink Dip Well FIrlWst Sink Deduct Meters
Sterilizes- Hose Bibs Wtr Usage: Mtrs
. Misc:.
FiXUln:s
Electric Contractor (for projeets Dot r~quiring 3D EIV Form)
Use J Nature of Work SANITARY SEwER REPAIR
Size
Material
Type
#
Conn. Type
Sanitary Sewer
4"
PVC
LATERAL
1
Storm Sewer
Wau:r Service
07 f07