HomeMy WebLinkAbout0152041 - Plumbing (cross connection) a) CITY OF OSHKOSH No 152041
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 613 N EAGLE ST Owner CITY OF OSHKOSH
Contractor D.R. HANSEN PLBG. Create Date 08/30/2012
Category 440-Industrial-Interior Plan
Inspector Rich Wood
Bathtub — Clothes Wshr Classrm Sink Surgeons Sink Roof Drain
Shower Deduct Meters
Lndry Tray Exam Sink Sterilizer Soda Disp
Whirlpool P Wtr Sewer Mtrs
P Sump Pump F Prep Sink RPZ Valve Coffee Maker Wtr Usage Mtrs
Lavatory San Sump/Pump Flr/Wst Sink Bidet
Site Drain Misc.
Toilet Water Softner Hand Sink Urinal Wait.St.
Fixtures
Kit Sink Standp Rec Lab Sink __ Beer Tap Ice Chest
Disposal Gar Drain Plaster Sink Dip Well
P Comm Ice Maker
Dishwasher Local Waste Sculry Sink Drink Ftn
Int Grease Trap
Floor Drain
Bar Sink Sery Sink Wash Ftn Ext Grease Trap
Hose Bibb Breakrm Sink Shamp Sink Catch Basin
Eye Wash Statn
Water Heater
Use/Nature Cross connection orders by Hydro Design correction. City owned building waived fees.
of Work
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Parcel Id#
1608690000
Valuation $500.00 Plan Approval $0.00 Permit Fees $0•00 ❑ Permit Voided I
Issued By
Date 08/30/2012
In the performance of this work, I agree to perform all work pursuant to rules governing the described construction.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party,if you perform the work
described in this permit application within an easement,the City strongly urges the permit applicant to contact the
easement holder(s)and to secure any necessary approvals before starting such activity.
Signature Date
Agent/Owner
Address 55 KNAPP ST OSHKOSH WI 54902 -3448 Telephone Number 233-1595
To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of
Inspection (i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone
Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.