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PLUMBING PERMIT - Os~kosh, Wisconsin Perml! N? 9265
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Date Lol No. Block Ward Addllion or Replat
OUTSIDE WORK
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NEW SEWEI WAUR STORMS lEES FEES RELAY S. SEWER WAUR STORMS FEES
From MaID to Curb Septic Tanks From Main to Curb
From Curb to BuUdlng r..L"r!..t- ¡-!:¡'I ~ Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO. NEW "P. USID RES NO. NEW REP. USEO lEES tlO. NEW REP. USED lEES
- - - -
Bath Tub Garbage Dlapooalo Catch Bulns
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Wuh Buin Dlabwuben - Conductors
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Water Cloeet Laundrernato Greue Catch Buins
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SiDk Water Softeners Sump Pump II< Ejectors
WaIør Heaters Sanllary Bubblers Bar and Soda Wutes
Shower Baths Urinala
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noor Dr8lu Dental Cuspidors
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Laundry Tube Senice Sinks
lupections Valuation of the Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Inspection Fees
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In the performance of this work the undersigned owner (or his euthorbed agent) of seid premises and his authorired Plumber hereby agree to be bounden by and
submit to all statutes, city ordinances, and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other uses will be made of the above connections except as hereinafter listed.
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