HomeMy WebLinkAbout0128060-Plumbing (laterals)
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O'SHKOSH
ON THE WATER
Job Address 3200 FERNAU CT
CITY OF OSHKOSH No 128060
PLUMBING PERMIT - APPLICATION AND RECORD
Owner CULLlGANS Create Date 12/05/2007
Plan
Contractor LAUDOLFF EXCAVATING & SEPTIC SERVICE Category 430 -Industrial-Exterior (laterals)
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 New laterals serving Culligan Warehouse. 2" water, 4" sanitary and 12" storm for parking lot drainage.
of Work
Coffee Maker
Int Grease Trap
Ext Grease Trap
RPZ Valve
Eye Wash Statn
Wtr Sewer Mtrs
Deduct Meters
Wtr Usage Mtrs
Valuation
Issued By
Size
Type
Lateral
#
Conn. Type
New
Parcelld #
Date 12/05/2007
Sanitary Sewer
4"
Material
Plastic
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}atId to secure.aw ne sary approvals before starting such activity.
//".~/ .~~--:.",,/
Signature ( ,~.. ~"
Storm Sewer
Plastic
Lateral
New
12"
Water Service
2"
Plastic
Lateral
New
$7,500.00 Plan Approval
$0.00 Permit Fees
$150.00 0 Permit Voided I
Address N3438 MAPLE LN
,
<Ageotl0wner
FOND DU LAC
WI 54935 - 0000 Telephone Number 920-923-0473
Date I:!- ~ >~o 7
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.
City of Oshkosh
Inspection Services Division
POBox 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax: (920) 236-5084
ON THE WATER
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 City 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.
OR
If vou are a contractor participating in the Permit Fee Account Svstem and have adequate funds. check here
if vou want this processed through vour account n
** Advisory - For applicable projects, an Electrical Installation Verification (EIV) form, signed by the Electrical
Contractor or Homeowner (for installations allowed to be performed by the homeowner) must be submitted
with the permit application. Applications submitted without an EIV when such is required, will not be
processed for Permit Issuance and will be returned for completion. ~ ~S(;-D
JobAddress J~ fVI'~v0- VaIUe(lncludinglabOrandmateriaIS)~~ F
Owner etA-tl",":) "" / Ct"NJ.,~~ CtatfContrac.tor ~ fb( q-c -t ~
DSingle Family dDuplex DMulti-Family DRental
Date /.J- - )-0)
Commercial
L s.: a.r tI /c. e :t::^- '--.
Dlndustrial
Number of Fixtures:
Bathtub Disposal Drink Ftn Catch Basin ~
Whirlpool Dishwasher Wait.St. Wash Ftn
Lavatory Sump Pump Ice Chest Urinal
Toilet Ejector/Grind Exam Sink Gar Drain
Res. Sink Water Softner Sculry Sink Soda Disp
Bar Sink Local Waste Hand Sink Coffee Maker
Water Heater Clothes Wshr F Prep Sink Comm. lee Maker
o Gas 0 Elect 0 PwrVnt Bidet Serv Sink Site Drain
Shower Beer Tap Int Grease Trap Roof Drain
Floor Drain Classrm Sink Ext Grease Trap Standp Rec
Lndry Tray Surgeons Sink R.P.Z. Valve Eye Wash Stn
Lab Sink Breakrm Sink Shamp Sink Wtr Sewer Mtrs
Plaster Sink Dip Well Flr/Wst Sink Deduct Meters
Steril izer Hose Bibs Wtr Usage Mtrs
Mise,
F ixtu res
Electric Contractor (for projects not requiring an EIV Form)
Use/Nature of Work
Size Material Type # Conn. Type
Sanitary Sewer '1 J1 / ;'.)r" /~I(/~I / ~tN
" / ).,;-h (, '-') ~U
Storm Sewer ItA /
Water Service .~ /4,Jlj~ ~J
d-- t'\. /
07/07