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Home My WebLink About0155716-Plumbing (storm sewer) � CITY OF OSHKOSH No 155716 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 11 ALLEN AVE Owner CYPRESS HOMES INC Create Date 05/20/2013 Contractor ZILLGES EXCAVATING Category 401 -Residential-Exterior(laterals) Plan Inspector Jerry Fabisch Bathtub 0 Clothes Wshr 0 Classrtn 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 Fir/Wst Sink 0 Bidet 0 Site Drain 0 Misc. p Toilet 0 Water Soitner 0 Hand Sink 0 Urinal 0 Wait.St. 0 Fixtures Kit Sink 0 Standp Rec 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 Hose Bibb 0 Breakrm Sink 0 Shamp Sink 0 Catch Basin 0 Eye Wash Statn 0 Water Heater 0 Use/Nature NSFR/installing storm sewer to house of Work Size Material Type # Conn.Type Sanitary Sewer Storm Sewer 4" Plastic Lateral 1 New Water Service Parcel Id# 1516580200 Valuation $500.00 Plan Approval $0.00 Permit Fees $50.00 ❑ Permit Voided i Issued By �� Date 05/20/2013 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)anc�to r any necessary approvals before starting such activity. Signature �.�� Date S'�2�1(1 AgenUOwner Address 1800 FOUNTAIN AVE OSHKOSH WI 54904 -1045 Telephone Number 231-1994 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. City of Oshkosh Inspection Services Division � P O Box 1130 � Oshkosh,WI 54903-1130 Phone:(920)236-5050 Fax:(920)236-5084 O u�(O�u I II\ I I 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 ar$100.00 plus the normal permit fee,which ever is greater. OR If vou are a contraclor participatin� in the Permit Fee Account Svstem and have adeguate�unds check here if vou want this nrocessed throu�h vour account �I **Advisory-For applicable projects, an Electrical Installation Verification(EI�form, signed by the Electrical Contractor or Homeowner(for installations allowed to be performed by the homeowner)mnst be snbmitted with the permit application. Applicadons snbmitted without an EIV when such is required, will not be processed for Permit Issuance and will be returned for compledon. Job Address I� �l�'(� 7 l VaIUC(Including labor and materials) 7 �4� Date J / �/r � Ow r ��'�SS �S Contractor Zr1ly�s W`�Gv',2'i 1 Single Family ❑Duplex ❑Multi-Family ❑Reotal ❑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 Cof�'ee 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 ❑Gas 0 Elect G PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr Clothes Wshr Hand Sink Wash Fntn Wtr Usage Mtr I.ndry Tray Lab Sink Catch Basin Misc Fi�ctures Electric Contractor(for projects not requiring an EIV Form) Use/Nature of Work Sf°✓�►^'� S ��✓\ Size Material Type # Conn.Type Sanitary Sewer Storm Sewer C�l� �V� Water Service 06/09