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Home My WebLink About0152142 - Plumbing (storm sewer lateral) CITY OF OSHKOSH No 152142 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Create Date 09/05/2012 Owner LINDA L GRANT Job Address 1405 CAMBRIDGE AV wn — -- - Category 401 =Residential-Exterior(laterals) Plan -- Contractor FREUND EXCAVATING __-- Inspector Jerry Fabisch t Me u Dedct Meters Shower Lndry Tray Bathtub Clothes Wshr Classrm Sink Surgeons Sink Roof Drain Wed Deduct Me ers Exam Sink Sterilizer Soda Disp --- ---- -_-- Wtr Usage Mtrs Mtrs F Prep Sink RPZ Valve Coffee Maker g Whirlpool _—_ Sump Pump Flr/ P Site Drain Misc. _ San Sump/ ump Wst Sink Bidet Fixtures Lavatory Urinal Wait.St.- Hand Sink Toilet Water Softner ---— --Beer Tap Ice Chest— Lab Sink — Kit Sink Standp Rec --- — - Disposal Gar Drain —__ Plaster Sink Dip Well Comm Ice Maker Scul ry Sink Drink Ftn Int Grease Trap Dishwasher _— Local Waste Wash Ftn Ext Grease Trap _ Floor Drain Bar Sink Sery Sink Sink Catch Basin Eye Wash Statn Shamp Sin Hose Bibb Breakrm Sink ---- -- Water Heater —_ Use/Nature '[SFRI installing storm sewer lateral to house of Work — — Size Material Type # Conn.Type Sanitary Sewer Storm Sewer 6" Plastic Lateral 1 New Water Service Parcel Id# 1310950000 $0.00 Permit Fees $50.00 ❑ Permit Voided] Valuation $2,600.00 Plan Approval Date 09/05/2012 Issued By 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. Date Signature Agent/Owner OMRO WI 54963 9724 Telephone Number 920-685-2196 Address 3135 DELHI RD —_- --------- - -- r,Type of To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit e and Phone Inspection (i.e. Footing,Service, Final, etc.),Access into Building if Secure (how do we gain entry),y our Name 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. City of Oshkosh Inspection Services Division PO Box 1130 Oshkosh,WI 54903-1130 Phone: (920)236-5050 Fax: (920)236-5084 01HK01H ON THE WATER Plumbing Permit Application I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described,the work to conform to the Wisconsin State Plumbing Code, in the performance of which all parties hereto agree to and are bound by said statutes. • Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI 54903-1128. Commencing work without permit(s)will result in fees being doubled or$100.00 plus the normal permit fee,which ever is greater. OR If you are a contractor participating in the Permit Fee Account System and have adequate funds, check here if you want this processed through your account **Advisory-For applicable projects, an Electrical Installation Verification(EIV)form, signed by the Electrical Contractor or Homeowner(for installations allowed to be performed by the homeowner)must be submitted with the permit application. Applications submitted without an EIV when such is required, will not be processed for Permit Issuance and will be/returned for completion. /J� Job Address jYo5 C4I J. n)1))rIp Value (Including labor and materials)/(Za) 'CIO Date Owner Contractor Den n l S Fr' e\ r1C\ [Single Family ❑Duplex ❑Multi-Family ['Rental ['Commercial ❑Industrial Number of Fixtures: Bathtub Sump Pump Plaster Sink Roof Drain Shower San.Sump/Pump Scullery Sink Soda Disp Whirlpool Water Softener Service Sink Coffee Mkr Lavatory Standpipe Rec Shamp Sink Site Drain Toilet Garage FD Surgeons Sink Waitrs Stn Kit Sink Local Waste Sterilizer Ice Chest Disposal Bar Sink RPZ Valve Comm Ice Maker Dishwasher Breakrm Sink Bidet Int Grease Trap Floor Drain Classrm Sink Urinal Ext Grease Trap Hose Bibb Exam Sink Beer Tap Eye Wash Stn Water Heater F Prep Sink Dipper Well Deduct Meter 0 Gas 0 Elect 0 PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr Lndry Tray Lab Sink Catch Basin Misc Fixtures Electric Contractor(for projects not requiring an EIV Form) Use/Nature of Work N 4' S a/e)fl 54-WE,P Size Material Type # Conn Type Sanitary Sewer , y Storm Sewer 6 �I RUC 1-✓7/GR�— / AiC `,o Water Service 06/09