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OSHKOSH
ON THE WATER
Job Address 2187 W 9TH AVE
CITY OF OSHKOSH No 127989
PLUMBING PERMIT - APPLICATION AND RECORD
Owner BRIAN R1LORI A L1CHTWALD Create Date 11/29/2007
Plan
Category 430 - Industrial-Exterior (laterals)
Contractor SEMENAS EXCAVATING INC.
Shower Water Softner Wait. St. Shamp Sink
Floor Drain Local Waste Ice Chest FlrlWst Sink
Lndry Tray Clothes Wshr Exam Sink Catch Basin
Disposal Bidet Sculry Sink Wash Ftn
Dishwasher Beer Tap Hand Sink Urinal
Sump Pump Lab Sink Plaster Sink Standp Rec
Classrm Sink Sterilizer Surgeons Sink Ice Maker
Breakrm Sink Dip Well F Prep Sink Gar Drain
Ejector/Grind Drink Ftn Serv Sink Soda Disp
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature Abandon water lateral at ROWand seal sanitary sewer for reuse to serve new A&W Drive-In.
of Work
Coffee Maker
lnt Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
i
Valuation
Issued By
Size
Material
Type
#
Conn. Type
$2,000.00 Plan Approval
$0.00 Permit Fees
$25.00 D Permit Voided I
Parcelld #
1311830100
Sanitary Sewer
Storm Sewer
Water Service
Date 11/29/2007
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 authori to enforce easement restrictions of which it is not a party, if you perform the work
described in this p r it application within easement, the City strongly urges the permit applicant to contact the
easement holder >. nd to secure any ssary approvals before starting such activity.
Signature
Date
1/-/9 '0/
Address W7380 FOREST AVE
FOND DU LAC
WI 54937 - 0000 Telephone Number 92-922-7906
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number, Type of
Inspection (i.e. 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.
DEC-20-200708:29A FROM:SEMENAS EXCAVATING & 19209227976
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TO: 19202365084
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REQUEST FOR EXCEPTION TO REQUIRED < <
SEWER AND WATER ABANDONMENT REGULATIONS'
Date 11- J q ~ 0 f
Address of building tt I 8 7 w . C) T t, /J tJ 6'.
Name of Owner Y U fY\ ! 8eAl#cI'5 J :I,u Ct
Address of owner '1~? s- tv G"t/t u e-,e Pit ~ 1:0-<111 \~ '5 e., ITa :2 (J6
/,v,te~6='N Qi it..,;'::t:"( (Pos-1-=r
The undersigned Master Plumber requests that the requirement for abandomnent of the
sewer and water laterals for this address not be required to meet the ordinance for
abandonment at the property line before raze or removal of the served structure. (Check
one or provide Information)
The utilities will be reused for new construction at this site within twelve months of
the date of request for exception. lfthe utilities will not be reused within this time
frame they will be properly abandoned at the property line per ordinance
requirements no later than twelve months from date of this request.
. The utilities will be properly abandoned after the structure is removed to make the
utilities accessible for abandonment The utilities will be secured against damage
during demolition and until they can be abandoned to meet the requirements of
ordinance. (Not to exceed 60 days)
.
Other reasons for the requested exception:
Master Certificate Number fV\ p ~ {
Mailing address to j> 3 8'0
Approved:
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Date /p1..' ~ . ()7
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