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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 9170
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l Lol Ho. ~ I Block I Ward I Addition or Re >lat
Due
OUTSIDE WORK
NIW SEW" WATER STORMS lEES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn to Curb Seplic Tank. From Main 10 Curb
From Curb 10 Building Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
REP.
FOES
NEW
REP. I USEO
FEES
NO.
NEW
USED
FEE'
REP.
USIO
NO.
Bath Tub
Garbage Dls~
Dlshwuhon
CUch Buins
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Conduclors
Wash Buin
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Greue Cuch Bulns
Wu... Cl_t
Laundrema!s
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J.ðó
SIDII:
Water Softeners
Sump Pump 8t Ejector.
Water Heue..
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Sanitary Bubblers
Bar and Soda Wule.
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Sho...... Baths
Urinals
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Floor DraiDa
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Denial CuRpido..
Laundry Tubo
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Service Sinko
Fee Verified. Receipled and Recorded
Received Permil and Inspocllon Fe..
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~uallon of Ihe Work Herein De.cribed
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In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by end
submit to all statutes. city ordinance.. and rule. and regulations prescribed by the Board of Public Works for the governmant of Plumbers.
It Is futher agreed by the undersigned that no other use. will be made of the above connections except as hereinafter listed.
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PLUMBING
I HæEBY CERTIFY THAT ALL OF THE PLUMBING IN THIS
cs- ;?30 F
MILL-CRAFT HOME, BUILDING NO.
IS IN ACCORDANCE WITH THE STATE OF WISCONSIN
PLUMBING CODE,
Iäte:
1-/3 -76
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SigMture
Title
I HæEBY CERTIFY THAT I HAVE INSPECTED THE ABOVE
NUMBERED JOB AND TO THE BEST OF MY KNOWlEI:GE FIND
IT TO BE IN CŒPLIANCE WITH THE ABOVE CODE,
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Inspected by:
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Title
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Subscribed and Sworn to Before Me This
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19 ;Zç'
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W paca. County. W:Jp!ónsin
NOtary Public
My Commission Expires
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