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HomeMy WebLinkAbout0015598-Building (raze) (11--lip) CITY OF OSHKOSH N9 15598 PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT ADDRESS k NDoc. G 0 e. PLAN NO. OWNER //u.c Y DESIGNER USE /NATURE OF WORK a 5 r ? C p e.� v t c‘Z= BUILDING CONTRACTOR ©j 1>c) e p ( Size W 1 1 e Sq. Ft. # Rooms # Stories ( Height Foundation (�c`e F- -5 Class of Const. Occupancy Permit /90 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 CPk.t -S .S-c..ic°d _Th .41 c e BT WH Disp WSoft CBasin Lav Sh DW DF San. Sewer WC FDr SP Ur Storm Sewer Sink LTub Eject SS Water Other FEES: Valuation !�� i Q r`� - ---� . / Pe Fee Paid $ Park Dedication $ ISSUED BY ��� AlK Date < i� Final /O.P. In the performance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE /P. /� 0 � Sl � AGENT /OWN H 7 GATE ADDRESS 6 2 2 `�j L° � ` S% n '+r 2 33- 3/3-11 TELEPHONE # RECORD OF SEWER AND WATER DISCONNECTIONS Date -- Address of Building / Name of Owner 171C1.4."_ lv 461 d4' 1• Address of Owner Sewer Sealed at Property Line 19 Water Disconnected at Property Line 19 by No sewer and water services to premises. I, the undersigned, owner or agent of the above described property, agree that all sewer and water services wil;,,,be sconnected nd sealed by a master plumber on or / before (7e ( t (Own: ent)) Approved for issuance of wrecking or movi1 •ermit. IIa t C •r rs.r �d .cii P1 .ubing Inspector