HomeMy WebLinkAbout0019940-Plumibng (laterals) CITY OF OSHKOSH N2 19940
46) PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG SIGN ❑ ZONING FLOOD PLAIN HEIGHT
z e_c_4 1 6 4 „,
ADDRESS — 3S S
//�� PLAN NO.
OWNER a/ 4Z
DESIGNER �+
USE /NATURE OF WORK `� = " 1 J -e--e
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 # . .2--e -
C_
BT WH Disp WSoft CBasin
_Lay Sh DW DF 1 / San. Sewer 7` ,, / " C
WC FDr SP Ur / Storm Sewer T f 0 C
Sink LTub Eject SS L Water / I
Other
FEES: Valuation $ / 0 0 • 0 d Permit Fee Paid $ 3 o 0 a v Park Dedication $
ISSUED BY CZ" at Date 6' - 9 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE cy�� Gect.e 'r r ° S' 6 s�' Y` /,3/ P-iv
AGENT /OWNER I DATE
I
ADDRESS
TELEPHONE #