HomeMy WebLinkAbout0056045-Plumbing (laterals) CITY OF OSHKOSH No 0056045
OSH OSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 565 GOLDEN IRIS DR Owner DUWAYNE JACOBSON Create Date 11/15/96
Contractor FOX VALLEY EXCAVATING Category 401 -Residential-Exterior (laterals) Plan
Bathtub Shower Ejector/Grind Dip Well F Prep Sink Gar Drain
Whirlpool Floor Drain Water Softner Drink Ftn Serv Sink Soda Disp
Lavatory Lndry Tray Local Waste Wait. St. Shamp Sink Coffee Maker
Toilet Lndry Stndp Clothes Wshr Ice Chest Flr/V1Ist Sink Int Grease Trap
Res. Sink Disposal Bidet
Bar Sink Dishwasher Beer Tap Sculry Sink Wash Ftn
Water Heater Sump Pump Dent. Oper. Hand Sink Urinal
Site Drain Classrm Sink Lab Sink Plaster Sink Standp Rec
Roof Drain Breakrm Sink Sterilizer Surgeons Sink Ice Maker
Use/Nature
of Work NSF
ize a ens ype onn. ype
Sanitary Sewer
4 Plastic Lateral 1 New
Storm Sewer
4 Plastic Lateral 1 New
Water Service
1 Copper Lateral 1 New
Valuation $680.00 - -
Issued By
rian r~pprovai $0.00 Permit Fees $30.00
Date 12/09/96
ermi of e
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 0 - 0 Telephone Number