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OSHKOSH ON THE WATER .lob Address 2519 OREGON ST Contractor RASMUSSEN PLUMBING Bathtub 0 Shower Whirlpool 0 Floor Drain Lavatory 0 Lndry Tray Toilet 0 Lndry Stndp Res. Sink 0 Disposal Bar Sink 0 Dishwasher Water Heater 1 Sump Pump Site Drain 0 Classrm Sink Roof Drain 0 Breakrm Sink CITY OF OSHKOSH PLUMBING PERMIT - APPLICATION AND RECORD Owner ROBERT/CYNTHIA CANNY JR Category 411 - Residential-Water Heaters 0 Ejector/Grind 0 Dip Well 0 F Prep Sink 0 0 WaterSoftner 0 Drink Ftn 0 ServSink 0 0 Local Waste 0 Wait. St. 0 ShampSink 0 0 ClothesWshr 0 Ice Chest 0 FIr/Wst Sink 0 0 Bidet 0 Exam Sink 0 Catch Basin 0 0 Beer Tap 0 SculrySink 0 Wash Ftn 0 0 Dent. Oper. 0 Hand Sink 0 Urinal 0 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0 No 102411 Create Date 06/24/2003 Plan Gar Drain Soda Disp Coffee Maker Int Grease Trap Ext Grease Trap Use/Nature SFR/Replace gas water heater. of Work Valuation Issued By Sanitary Sewer Storm Sewer Water Service Size Material Type # $450.00 Plan Approval $0.00 Permit Fees Conn. Type 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 $20.00 Date 06/24/2003 Permit Voided In the performance of this work, I agree to perform all work pursuant to rules governing the described construction. Signature Date Agent/Owner Address 1914 GREENBRIAR TRL OSHKOSH WI 54904 - 8887 Telephone Number 920-233-6747 06L2§/2003 06:50 2336?4? J RASHUSSEN PAGE 0i/0i OShkosh