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OSHKOSH
ON THE WATER
Job Address 15 E LINCOLN AVE
CITY OF OSHKOSH
No
128214
PLUMBING PERMIT - APPLICATION AND RECORD
Shower
Floor Drain
Lndry Tray
Disposal
Dishwasher
Sump Pump
Classrm Sink
Breakrm Sink
Ejector/Grind
Owner ROSE A SUNDQUIST MARITAL TRUST Create Date 12/19/2007
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
Sterilizer Surgeons Sink Ice Maker Deduct Meters
Dip Well F Prep Sink Gar Drain Wtr Usage Mtrs
Drink Ftn Serv Sink Soda Disp
Contractor M P KELLY
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
Site Drain
Roof Drain
Misc.
Fixtures
Use/Nature
of Work
SFR / REPLACE TOILET **check #8965
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id #
1000540000
Plan Approval
$0.00
$25.00 0 Permit Voided I
Valuation $439.00
Issued By OO)~
Permit Fees
Date 12/19/2007
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
OSHKOSH
Address 665 N MAIN ST
WI 54901 - 4431 Telephone Number 231-1750
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-U30
Phone: (920) -236':'50~0
Fax: (920) 23&:5084
PlumbingPerlTlifApplication
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1 hereby apply for a permit to do and install the following plumbirtg on thepretnises hereinafter described, the work to conf,t}ttnJo the
Wisconsin State Plumbing Code, in the performance of which aU parties hereto agr:ee tq and are bound by said statute.s. .
· Application(s) and fee(s) can be broughfto City lIall, Room:405 QU11ailedto IDSpection Services, PO Box 11'28,
Oshkosh WI 54903-1128. Commencing work without:perrnit(s)willr~sultin fees beingdouQ:le~.or $100 .00 plu~the
normal permittee, which ever is greater. .
~ ..... . . .
I Quare a contractor artici ati1iin.tlifi .Permit. 'eeAccouI'Sslema.niLhave.dde
{f vou want this processed throughV(),ur acc.ountTJ ....
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?:/tontract~r
'OM~\lti~Fa~iIY
Number of Fixtures:
Bathtub
Whirlpool
Lavatory
Toilet
Res. Sink
Bar Sink
Water Heater
o Gas 0 Elect 0 PwrVnt
.~
iDillPosal
Dishwasher
Sump Pump
Ejector/Grind .
Water Sortner
Locat'waste
Clothes Wshr
Bidet
Beer Tap
Classrm -Sink
Surgeons Sink
BreakmrSilik
Dip Well
~
.,,~
...~
.~
+-
~
Shower
Fioor Drain
Uldi'y Tray.
Lab Sink
Plaster Sink'
Sterilizer
Misc.
Fixtures
~
"
".
~
DrinkFtn
Wait.St.
Ice Chest
;Exam Sink
~~!!Y Sink
..a~t1~~~i~~. ".
F Prep'Stilk
Se-rv.Sink
Int'q,r~~e Trap
;;Ext(Qi;ease :Tmp.
'. . RiP iZ: Valve'
.~hamp.:Si.lik
,'P1rl.WsISlnk.
. I....
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check here
Catch Basin
Wash Fro.
Urinal
Gar Drain
Soda Dillp
Coffee Maker
Ice Maker
Site DraiJl
dRQO.f.Drain '.
'Stitnijp Rei;
. EYe.w~~h;Stn
;wtr Sewer'Mtrs
Deduct:Meters
'WttlJsage Mtrs
Electric Contractor
" .Oll"'DJElectriK~nst~liation'Veriticati~ri:"foJ;m att.ached
~-I-~~_l). ... .
. , . ,.
. .
Use I Nature of Work
Material
Sanitary Sewer
iStormSewer
WaterService
TyPe.,"
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