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HomeMy WebLinkAbout0028618-Local Waste & Standpipe ~ CITY OF OSHKOSH N2 PERMIT - APPLICATION AND RECORD 28618 TYPE: BLDG 0 HTG 0 ELEC 0 PLBG ~ SIGN 0 ZONING FLOOD PLAIN HEIGHT ~~~~E~~ - - - - - - - -; ~; - )t-f[S;- - - - - - - - - - - - - - - - - - - - - - - ~L~~ -N~- - - - - - - - - - - OWNER 0 S' ~ DESIGNER USElNATUREOFWORK F~ ~~A /~#"- ~/;29/ BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Occupancy Permit Foundation Class of Const. I HEATING CONTRACTOR Heat 0 AlC 0 Vent 0 Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR Electric Servo New 0 Change 0 Temp 0 Type _ Volts_ Amps ~ Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR I _BT _WH () C~ ~ _FDr _Disp _DW _SP _ WSoft _DF _ CBasin _Lav _Sh _ San. Sewer _WC _Ur _ Storm Sewer _Sink Other _LTub ~. Ej~ r- _SS /' . ~t~ /- Ifct->,~ ff Cf- /- ~ FEES: Valuation $ ISSUED BY ;)-00_ 00 vu)2- Permit Fee Paid $ Date / / D. 0 I (:I V/ S-//f-/72- / /, Park Dedication $ Final/O.P. LJ - ') -1 ';).. wor,k I agree to perform all work pursuant to rules governing the described construction. . I SIGNATURE ~c~ ~4~ / /l) ~ Ar-JTIOWNE I ADDRESS If; JZ)U/' ,~Z~. ,/0-e_ 6- (t9d.- DATE dJ~ ;:c~Q<;~ ~ !'~ /~ TELEPHONE # AmlRESS / <5 :3 ~ S, PL1lIIBIlC PEllHt~LI~~/ 7'.2-- . PElIHI'II;:L s-U g 0IlIIE1!. 1) . ~ PLIIIlBU 0 ~ NAtoU OF YOlUC F' ~ ~ /If' / ~ # ~ 72-.9/ I NEt~ RELAY REPAIR nrt'ZRIOB. SAN SEW I , ~At!R Bachcub Sump Purno 1:l:'U LavaCorv Ejector Toilec Water Softener ON OAT.! msn en OR DAtE ltic. Sink Drinkin Q' Fountain i-/l Sink(other) n....;...<I1 ;::: W"'teTheater Slop Sink Grease Tran Floor Drain / Local Waste , Laundry Tub Site Drain Disuosal / Laundrv Standuiue i Dishwasher Catch Basin ** Violat:ioft not:es Oft the reverse sidel