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� CITY OF OSHKOSH No 154927
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1301 CEAPE AVE Owner CHER HER/SHANNA L SANFORD Create Date 04/03/2013
Contractor MR ROOTER OF THE FOX VALLEY Category 401 -Residential-Exterior(laterals) Plan
Inspector Jon Mueller
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
Whirlpool 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 0
Disposal 0 Gar Drain 0 Plaster Sink
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 SFR/Pipe burst new 4"PVC sanitray and pull in new 1 1/4"poly water laterals.
of Work
Size Materiai Type # Conn.Type
Sanitary Sewer 4" Plastic Lateral 1 Relay
Storm Sewer
WaterService 11/4" Plastic Lateral 1 Relay
Parcel Id#
0804790000
Valuation $2,800.00 Plan Approval $0.00 Pertnit Fees $100.00 ❑ Permit Voided I
Issued By �(A/�- Date 04/03/2013
In the performance of this work, I agree to perform a�l work pursuant to rules governing the described construction.
While the Ciry of Oshkosh has no authoriry 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 app�icant to contact the
easement hoider(s)and to secure any necessary approvals before starting such activity.
Signature Date
AgenUOwner
Address PO BOX 1141 APPLETON WI 54912 -1141 Telephone Number 920-687-9178
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.
E
Wentz, Sandra `
From: PLUMBING PERMIT APPLICATION [Permit_App_Plumbing@ci.oshkosh.wi.us]
Sent: Wednesday, April 03, 2013 9:46 AM
To: Inspections, Inspections
: Subject: PLUMBING Permit Application
PLUMBING PERMIT APPLICATION
Date:4/3/2013 9:46:22 AM
Permit Fee Account System: YES
Job Address: 1301 ceape ave
Owner: Cher Her/Shanna Sanford
Contractor: Mr Rooter Plumbing
Use Category: Single Family
FIXTURES
Bathtub: Sump Pump: Plaster Roof
Sink: Drain:
Shower: San. Scullery Soda
Sump/Pump: Sink: Disp:
Whirlpool• �'ater Service Coffee
' Softener: Sink: Mkr:
Lavatory: Standpipe Shamp Site
Rec: Sink: Drain:
Toilet: Garage FD: Surgeons Waitrs
Sink: Stn:
Kit Sink: Local Waste: Sterilizer: Ice Chest:
Comm
Disposal: Bar Sink: �lVe: Ice
Maker:
Breakrm Int
Dishwasher: Sink: Bidet: Grease
Trap:
Floor Classrm Ext
Drain: Sink: Urinal: Grease
Trap:
Hose Bibb: Exam Sink: Beer Eye Wash
Tap: Stn:
Water Dipper Deduct
Heater: F Prep Sink: well: Meter:
i
f
4'
Drink Wtr
Floor Sink: Fntn: Sewer
Mtr:
Clothes Wash wtr
Wshr: Hand Sink: Fntn: Usage
Mtr:
Lndry Lab Sink: Catch Misc
Tray: Basin: Fixtures:
*USE/NATURE OF WORK pipe burst new sanitary sewer and pull in new water
*VALUE 2800.00
ELECTRIC CONTRACTOR
Size Material Type # Conn. Type
Sanitary Sewer
Storm Sewer
Water Service
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