HomeMy WebLinkAbout0000333-Plumbing (deduct water meter)CITY OF OSHKOSH No 00333
PERMIT — APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG JA, SIGN ❑ ZONING FLOOD PLAIN HEIGHT
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ADDRESS �r �CC Y �� !� _ PLAN NO.
OWNER
DESIGNER
BUILDING CONTRACTOR
Size
Foundation
Sq. Ft
HEATING CONTRACTOR —
Heat ❑ A/C ❑ Vent ❑ Fuel /System
# Rooms # Stories
Class of Const.
Heat Loss
ELECTRIC CONTRACTOR.
Electric Serv. New ❑ Change ❑ Temp ❑ Type
Fixtures Switches Receptacles
Volts
Circuits
Height .
Occupancy Permit
BTU'S
Amps
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
R
DATE
ADDRESS
TELEPHONE #
FEES: Valuation $��
PLUMBING CONTRACTOR'
_�
f `''�' ��
ISSUED BY ��
Date
J
/ /��
Final /O.P.
BT
WH
Disp
WSoft
CBasin
Lav
Sh
DW
DF
San. Sewer
WC
FDr
SP
Ur
Storm Sewer
Sink
LTub
Eject
SS
Water
Other
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
R
DATE
ADDRESS
TELEPHONE #
FEES: Valuation $��
ermit Fee Paid $
- t
Park Dedication $
ISSUED BY ��
Date
J
/ /��
Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE
R
DATE
ADDRESS
TELEPHONE #
METERS) PERMIT
Name of Owner 14 Af Fir � ; /71
Address of Owner
Meter Installed At
Meter(s) Size /
Meter (s) Use
Date
fr�i r.
(Diagram of Use)
7-0 e,k �
sCrir,� ,T
Meter will be installed and used according to the above information,
ell
' Owner or Agent
To Water Utility: Requirements have been met to purchase and
install meter(s) at the above address for size and use indicated.
Plumbing Inspector