HomeMy WebLinkAbout0010926-Plumbing (storm sewer) CITY OF OSHKOSH No 1
PERMIT APPLICATION AND RECORD
TYPE: BLDG HTG ELEC PLBGSIGN ZONING FLOOD PLAIN HEIGHT
ADDRESS 3 575 Gel .97/1_ PLAN NO.
OWNER 4% e
DESIGNER
USE /NATURE OF WORK ":1 e�L�.v
BUILDING CONTRACTOR
Size Sq. Ft. Rooms Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat A/C Vent Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New Change Temp Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR A i,'��-C.'1 --..1'%
BT WH Disp WSoft CBasin
Lav Sh DW DF San. Sewer A
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
`.rte s
FEES: Valuation 7 Permit Fee Paid Park Dedication
ISSUED BY a— u -r'"" Date re9,-//r4 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE 8!s kV WO (9 43 OS 1 6 /1 AGENT /OWNER D E
ADDRESS 804 w t T21V- K V e 3( C)
TELEPHONE
PLUMBINC PERMIT APPLICATION
ADDRESS. _3 5
4. 747 DATE f 2J�
PE' /092C
OWNER /..b. 4 o_ _L PLUMBER E
NATURE OP WORK d
NEW RELAY REPAIR INTERIOR
SEW
WATER
am Bathtub
■y x Catch Basin
Lavato In Grease Tra
NSPE ON DATE INSPECTION DAZE Toilet S P
Kit. Sink III Local Waste
Sink other) Site Drain
COsi/C./e_ I LeVA 7 ia
Laundry Stand Pipe
-1 4 Laund Tra
Disposal Wat. Softner
Dishwas D Fo
r•. 1/ e."...., Water Heater E ector
Future outlets
Violat'oa antes on t e reverse R•de