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� CITY OF OSHKOSH No oo��ss�
OSHKOSH PLUMBING PERMIT -APPUCATION AND RECORD
ON THE WATER
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Job Address 822 E NEW YORK AVE Owner AIEXANDER A MERTEN Create Date 05/30/2000 3
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Contractor FARMERS SUPPLY CO Category 411 -Residential-Water Heaters 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 1 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
REPLACE WTR HTR
Size Material Type # Conn.Type
Sanitary Sewer
Storm Sewer
Water Service
Valuation $400.00 Plan Approval $0.00 Permit Fees $10.00
Issued By �.�— Date 05/30/2000
� Permit Voided�
In the perFormance of this work,I agree to perform all work pursuant to rules goveming the described construction.
Signature ����.f/ ���,����:C%.--� Date S'_ 3�,-�,�
AgenUOwner
Address 34 W 7TH AVE OSHKOSH WI 54902 -0000 Telephone Number 235-6970