HomeMy WebLinkAbout0154806-Plumbing (cap laterals) � CITY OF OSHKOSH wo �5asos
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1718 W 9TH AVE _ _ Owner 9TH AND 7TH STREET LLC Create Date 03/21/2013
Contractor EGBERT EXCAVATING INC _ __ Category �-�.,��{.EMerior Laterals Plan
Inspector Jerry Fabisch _ __ _ `�� � �,���fi���
Bathtub 0 Clothes Wshr _ 0 Classrm Sink 0 Surgeons Sink 0 Roof Drain 0 Deduct Meters 0
Shower _0 Lndry Tray 0 Exam Sink 0 Sterilizer 0 Soda Disp 0 Wtr Sewer Mtrs 0
Whiripool 0 Sump Pump 0 F Prep Sink 0 RPZ Valve 0 Coffee Maker 0 Wtr Usage Mtrs 0
Lavatory _ 0 San Sump/Pump 0 Flr/Wst Sink 0 Bidet 0 Site Drain 0 Misc. p
Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. � Fixtures
Kit Sink 0 Standp Rec 0 Lab Sink 0 Beer Tap 0 Ice Chest p
Disposal 0 Gar Drain 0 Plaster Sink _ 0 Dip Well 0 Comm Ice Maker 0
Dishwasher _ 0 Local Waste _ 0 Sculry Sink _ 0 Drink Ftn 0 Int Grease Trap 0
Floor Drain 0 Bar Sink _ 0 Serv Sink _ 0 Wash Ftn __0 Ext Grease Trap 0
Hose Bibb 0 Breakrm Sink 0 Shamp Sink _ 0 Catch Basin 0 Eye Wash Statn 0
Water Heater 0
Use/Nature £6ht�f�capping water and sewer laterals ------- — —�
of Work ����u
;I
----- - - — �
Size Material Type # Conn.Type
Sanitary Sewer 6" Vitrified Clay Lateral 1 Aband
Storm Sewer
Water Service 1" Iron Lateral 1 Aband
Parcel Id#
0613010000
Valuation _ $500.00 Plan Approval $0.00 Permit Fees $30.00 ❑ Permit Voided
Issued By � Date 03/21/2013
In the performance of this work, I agree to pertorm 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)a to secure any ne ssary pprovals before starting such activity.
Signature Date �� � �
Agent/Owner
Address PO BOX 462 GREEN LAKE WI 54941 -0462 Telephone Number 294-6668
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.