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Home My WebLink About0158283-Plumbing (laterals) � CITY OF OSHKOSH No 158283 OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD ON THE WATER Job Address 3211 ELK RIDGE DR Owner MIDWEST GENERAL CONTRACTORS Create Date 10/15/2013 Contractor IMMEL, ROBT J EXCAVATING INC Category 444_Commercial-Exterior Laterals Plan E7-516-1013-P Inspector Jerry Fabisch 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 FldWst Sink 0 Bidet 0 Site Drain 0 Misc. p Toilet 0 Water Softner 0 Hand Sink 0 Urinal 0 Wait.St. 0 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 COMM/exterior sanitary sewer and water laterals for new apartment building � of Work I , Size Material Type # Conn.Type Sanitary Sewer 4" Plastic Lateral 1 New Storm Sewer Water Service 2" Plastic Lateral 1 New Parcel Id# Valuation $8, 0.00 P val $0.00 Permit Fees $100.00 ❑ Permit Voided' Issued By � y, Date 10/16/2013 In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work described in this permit application within an easement,the Ciry strongly urges the permit applicant to contact the easement holder(s)and to secure any necessary approvals before starting such activity. Signature �y„f„ �,�.,� Date J� — �� . AgenUOwner Address PO BOX 135 GREENVILLE WI 54942 -0000 Telephone Number 920-757-5906 To schedule inspections please call the Inspection Request line at 236-5128 noting the Address, Permit Number,Type of : Inspection(i.e. Footing,Service, Final,etc.),Access into Building if Secure(how do we gain entry),your Name and Phone Number. Unless specified otherwise,we will assume the project is ready at the time the request is received. Work may continue if the inspection is not performed within two business days from the time the project is ready. City of Oshkosh Inspection Services Division � P O Box 1130 � Oshkosh,WI 54903-1130 Phone: (920)236-5050 F�:�9z°,2;6-s°g4 OlHK01H �� ON THE WATER Plumbing Permit Application I hereby apply for a permit to do and install the following plumbing on the premises hereinafter described,the work to conform to the Wisconsin State Plumbing Code,in the performance of which all parties hereto agree to and are bound by said statutes. • Application(s)and fee(s)can be brought to City Hall,Room 205 or mailed to Inspection Services,PO Box 1128,Oshkosh WI 54903-1128. Commencing work without permit(s)will result in fees being doubled or$]00.00 plus the normal permit fee,which ever is greater. OR If vou are a contractor narticipatin� in the Permit Fee Account Svstem and have adeauate fz�nds check here if'you want this processed throu�vour account n **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)must be snbmitted with the permit application. Applications snbmitted without an EIV when snch is reqnired, will not be processed for Permit Issnance and will be returned for completion. $ Job Address 3�)( �)k 2.�1�"G �. Va�UC(Including laborand materials) J � ��"• �� Date 1� `��'�� Owner M�dwcf� �Y�zl�� cwf Contractor �. S � r*�r� kXc. ❑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 CofYee Mkr La��atory 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;J Elect C PwrVnt Floor Sink Drink Fntn Wtr Sewer Mtr Clothes Wshr Hand Sink Wash Fnm Wtr Usage Mtr Lndry Tray I,ab Sink Catch Basin Misc Fiatures Electric Contractor(for projects not requiring an EIV Form) Use/Nature of Work Size Material Type # Conn.Type Sanitary Sewer �l �' I �''� S c1.y� Storm Sewer Water Service �� P�y 06/09