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� CITY OF OSHKOSH No 0073564
OSHKOSH PLUMBING PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2807 NEWPORT AVE Owner Create Date 10/13/99
Contractor RUSCH CONSTRUCTION Category 401 -Residential-Exterior(laterals) Plan
Bathtub Shower Ejector/Grind Dip Well F Prep Sink Gar Drain
Whirlpool Floor Drain Water Softner Drink Ftn Serv 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 Grease Trap
Res.Sink Disposal Bidet Exam Sink Catch Basin Ext Grease Trap
Bar Sink Dishwasher 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
NSFR
Size Material Type # Conn.Type
Sanitary Sewer
4 Plastic Lateral 1 New
Storm Sewer
4 Plastic Lateral 1 New
Water Service
1 Plastic Lateral 1 New
Valuation $1,500.00 Plan Approval $0.00 Permit Fees $30.00
Issued By Date 10/13/99
� Permit Voided j
In the performance of this work,I agree to perform all work pursuant to rules governing the described construction.
Signature Date
AgenUOwner
Address 3807A STATE RD 21 Oshkosh WI 54904 -0000 Telephone Number 231-8203