HomeMy WebLinkAbout0061702-Plumbing (Sewer connection) (1)1 CITY OF OSHKOSH No 0061702
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 3190 JACKSON ST Owner SOREN MAY Create Date 12/16/97
Contractor HOMEOWNER Category 410-Residential-Interior Plan
Bathtub 1 Shower Ejector/Grind Dip Well F Prep Sink Gar Drain
Whirlpool Floor Drain 1 Water Softner Drink Ftn Sery Sink Soda Disp
Lavatory Lndry Tray Local Waste Wait.St Shamp Sink Coffee Maker
Toilet Lndry Stndp Clothes Wshr Ice Chest Flr/Wst Sink Int GreaseTrap
Res.Sink 1 Disposal Bidet Exam Sink Catch Basin Ext Grease Trap
Bar Sink Dishwasher 1 Beer Tap Sculry Sink Wash Ftn
Water Heater Sump Pump Dent.Oper. Hand Sink Urinal
Site Drain Classrm Sink Lab Sink Plaster Sink Standp Rec
Roof Drain Breakrm Sink Sterilizer Surgeons Sink Ice Maker
Use/Nature
of Work HOMEOWNER PERMIT TO CORRECT PLUMBING FOR CONNECTION TO PUBLIC SEWER SYSTEM.
Size Material Type # Conn.Type
Storm Water
Valuation $500.00 Plan Approval $0.00 Permit Fees $16.00
Issued By Date 12/16/97
Permit Voided
The undersigned,in applying for a plumbing permit to install plumbing in a single family home owned and occupied as the
principle residence of the undersigned,hereby acknowledges,per Wisconsin State Statutes,ss 145.06,that other individuals
will not be employed to assist with th ork described by this permit If an individual will be employed to install plumbing
the work involved must be covered a permit issued to a properly licensed Master Plumber.
I i
In the performance of this work, I ag o perform all work pursuant to rules governing the described construction. /
Signature .. Date n .N t lQ_�l
Agent/Owner
Address 3190 JACKSON ST OSHKOSH WI 54901 - 1206 Telephone Number