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� CITY OF OSHKOSH No86937
OSHKOSH ELECTRIC PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 214 W MELVIN AVE Owner MARK W&WENDY WIEGMAN Create Date 06/21/2001
Contractor WITZKE ELECTRIC Category 612-Residentiai-Single Family Addition/R Plan
Service New � Change � Temp Type QOverhead 0 Underground �
Voits Circuits Fixtures
Amps Switches Receptacles
Appliances
Use/Nature of EPLACE SERVICE MAST
Work
Fees: Valuation $200.00 Plan Approval $0.00 Permit Fee Paid $20.00
Issued By: • "��f�E�. Date O6/21/2001
� Perrnit Voided I
in the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date
AgenUOwner
Address PO BOX 102 155 E PACKER AVE OSHKOSH WI 54903 - 102 Telephone Number (920)235-6572