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OSHKOSH
ON THE WATER
Job Address 3355 HARBOR BAY RD
CITY OF OSHKOSH
PLUMBING PERMIT - APPLICATION AND RECORD
Owner
CLASSIC HOMES BY KUBA
Contractor
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Use/Nature
of Work
FOX VALLEY EXCAVATING
Shower
Floor Drain
Lndry Tray
Lndry Stndp
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Category 401 - Residential-Exterior (laterals)
Ejector/Grind Dip Well F Prep Sink
Water Softner Drink Ftn Serv Sink
Local Waste Wait. St. Shamp Sink
Clothes Wshr Ice Chest FlrlWst Sink
Bidet Exam Sink Catch Basin
Beer Tap Sculry Sink Wash Ftn
Dent. Oper. Hand Sink Urinal
Lab Sink Plaster Sink Standp Rec
Sterilizer Surgeons Sink Ice Maker
NSF OUTSIDE PLBG
No 0050704
Create Date 01/25/96
Plan
Gar Drain
Soda Disp
Coffee Maker
Int Grease Trap
Ext Grease Trap
Sanitary Sewer
Storm Sewer
Water Service
Size
Material
Type
#
Conn. Type
Issued By
Valuation /1900 'c>O .~
4
Plastic
Lateral
New
Date 01/30/96
Copper
Lateral
New
Permit Fees
$20.00
U Permit Voided
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature
Address
WI 54901 - 0000
Agent/Owner
Oshkosh
Telephone Number
.
Date