HomeMy WebLinkAbout0126833-Plumbing (sewer lateral)
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OSHKOSH
ON THE~WATER
Job Address 890 CONCORDIA AVE
i
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
CITY OF OSHKOSH
No
126833
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner THOMAS E/LESLlE BURNS Create Date 09/18/2007
Category 410 - Residential-Interior 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
Steri I izer Surgeons Sink Ice Maker Deduct Meters
Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Drink Ftn Serv Sink Soda Disp
Repair sanitary sewer. "Inspection request to Plumbing Inspector is required per MC section 20 before work is to be covered:'
Size Material Type # Conn. Type
Sanitary Sewer 4" Iron Lateral 1 Repair
Storm Sewer
Water Service
Parcelld #
1310290000
$1,000.00
$0.00
$50.00 D Permit Voided I
Plan Approval
Permit Fees
Date 09/18/2007
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 55 KNAPP ST
OSHKOSH
WI 54902 - 3448 Telephone Number 233-1595
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (Le. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
.
~"'!! !3~07","~?:,_~~,_, ._. ~ 920..?337466
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DR HANSEN PLUMBING
PAGE 01
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Ci~; ojf O.bJ.:osh
In.,?cc\~Oi1 Services Dh'ision
Pcncx11JO
O~~lJ.:(!$b.. WI 54903-1130
}'co~e: (920) 236-5050
fa_": ,;'l2C') 236-508.1
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~OlB
elf,! TIol wl\H~
Plumbing Permit Application
! t.e ~l.y r.Pi1ly for a permit to do md install the following plumbing OQ the premises hereinafter described,. the work to confonn to tbl:
\'Ii.st;Ol'l.5Lo State Plumbing Code, in the penormanc.e ofwbich all parties heretp Clgree to md are bound by said statutes.
.. /',P?lic:ltion(s) and fec.(s) can be brought to City Hall, Room 205 or mailccl to Inspection Services, PO Box. 1128,
O;;hko~;h W1 54903-1128. Commencing work without permit(s) will result in fees being doubled or $100.00 plus the
ncnnaJ permit fee, which ever is greater.
OR
l!-l.'Q.t._El.!L2, C~/l.troc(or llfJJlicfrNJtfTlH !J1.J~~ermtt fee. A~~tmr SV,ftqm lL'fJrf. have odeg,uat.e fUlld~huk ne.r...t
i..L.'i.Q.'-!._~':..~W.LLbJ.J-JlLQ.f.~ J.hrou~h 'VO~__lInt 1Sl . .
.7 ,....-. . '
,I"', Add,ess gqo C ~"" c .....,. "\.Valo. (,"'I""~'b~.6: 00 - ~ <> j).,e~,
Owner ~\.) €.. ~.s . !-.. Contractor U.. w~~ ~ ~ ~ _
~gle Fn~ily DDuplex tt{Multi-Family DRental OComm~rc:lal; 'OIndustrial .
N\lmber or Fixtures:
~ :-~. :S"i\k
-~-/
Dl.~po~al
Dishwaahe-r
Sump Pump
EjeotorlGrind
W'I.~r So/Qlet
l..ccal Waste
Clolt.Q$ WsllI'
Bjdet
Beer Tap
CI!.m'll) Sink:
SurJ,:eot\S Siny.
BTt,k:nn Sink
J.>.p Well
Hose Sib~
.' . ',- . .
DrillkFtn Catch tlasin
Wail. Sl. WiI$h rl3'l
Ice Che:~l UrinRI
EMm Sink Gat Drain
SCLllry Sink Soda Di~
Hand Sink CofTC1: Makn
f p,.e~ Sin\( Comm.'lce Ma~c:-
SC1\' Sink Site Drain
Int OreLSc Tnl'p Roof Dtail'l
ExL Grnse Trail S\llsI4l' Rec
R.P.2. Valve 9.y~ Wash S\n
Shamp Sink Wtt Sewer Ml:'I's
FlrlWgl Sink Deducl M\:l~rs
Wll' Uuge M tfl
1'~'h'u'.)
\"'l-i'~r-'x.1
1..l',,~~C~'
";.,ld
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Ekctric Contractor
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DElectric'lnstaUatfon Verification form attacht:c
Of Repl'Cetnel1 t) . .
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