HomeMy WebLinkAbout0028435-Plumbing (abandon sanitary sewer) CITY OF OSHKOSH N2 28435
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG X SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS / PLAN NO.
OWNER / ( 0 - - 3 - - , 1 - - L . . . _
DESIGNER
/1 __-_ "gja-...-r..-..------
USE /NATURE OF WORK
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 1
BT WH Iffisp WSoft CBasin
Lav Sh DW DF San. Sewer
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water
Other
FEES: Valuation $ SD ^ to Permit Fee Paid $ A9 ., O d Park Dedication $
ISSUED BY C Date W -)-- Final /O.P. c --1- 1 - 9 d
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE g 5761? Z
A E WST DATE
ADDRESS
TELEPHONE #
PURSING PERMIT APPLICATION
ADDRESS O 2.- DATE __�/ 9 2— PERNIT# ) FS K_3
OWNER it ,7►��, . �.c.ca~. PLDMBEB .e----
NATURE OF WORE W4.-- `-
NEW RELAY REPAIR INTERIOR
SAN SEW # #
WATER ,Bathtub Sump Pump
•
to Y A. Lavin. E'ector
Toilet Water Softener
;NSPECTION DATE INSPECTION DATE Kit. Sink Drinkin g Fount
Sink(other) flrina1
r S' Waterheater
Shower Slop Sink
Grease Trap
Floor Drain Local Waste
Laundry Tub Site Drain
Disposal Laundry Standpipe
....,T Dishwasher Catch Basin
** Violation notes on the reverse sidel