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Home My WebLink About0041152-Plumbing (well to city water) �� CITY OF OSHKOSH N� 41152 � PERMIT - APPLICATION AND RECORD ' TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG (�SIGN ❑ ZONING FLOOD PLAIN HEIGHT ` - - - - - - - - - - - - - - - - - - - - - - - - _'G: _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS �Z � PLAN NO. OWNER �' �7 DESIGNER . USE/NATU OF WORK � � Gt--t BUILDING CON7RACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR Heat ❑ A/C ❑ Vent ❑ Fuel/System Heat Loss BTU'S ELECTRIC CONTRACTOR Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches Receptacles Circuits PLUMBING CONTRACTOR � _BT —WH _Disp — o —CBasin '�� _Lav —Sh _DW —DF —San. Sewer _WC _FDr —SP —Ur —Storm Sewer —Sink —LTub _Eject —SS —Water Other � FEES: Valuation $ �'�� Permit Fee Paid $ � � ' � � Park Dedication $ ISSUED BY Date � � � Final/O.P. tn the pertormance of this work I agree to perform all work pursuant to rules governing the described construction. SIGNATURE �� 9y AGE /O ER DATE ADDRESS TELEPHONE N