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:¡¡ PLUMBING PERMIT - O.hkosh, WI",.".;" ..... N? 1239 ><
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1 Lot No. I Block I Ward I Addition or Replat
Dale
OUTSIDE WORK
-
STORMS
fEES
NEW
SEWEll
WAf"'"
7
fEES
'EIAY
S. SEWE'
WATER
STORMS
fEES
7
From Main to Curb
From Main 10 Curb
Seplic Tanks
From C...b to Building
/
Electric Pumps
From Curb 10 Building
Repair
NO.
WaI.... CIONt
f--
/ INSIDE WORK
NEW
NEW
REP. I USEO
FEES
NO.
NEW
REP.
USE.
"ES
~I)
Bath Tub
Calch Bulna
tt
ConductOri
-,-
areue Catch Bulna
Laundramafp
Water Softe~.
Sump Pump 8< Ejectorl
SIDk
Waler Healen
~
----
Bar and Soda Wutes
Sanitary Bubblen
Floor Dr8IDs
Urinals
~don
Show.... Batbs
Laundry Tubo
Iaspec:l1ons ------------
----.-------.---.------.-.-----.-----____Oulside
---------------_._-------------------------_------Inside
_.-----1---------1 I Service Sinks
~I~~~~~~
----------Ci¡:,-T;;;~~;;;----------------'---------
Fee Verified, Receipled and Recorded
Received Permit and Inspection F-
-------.--------------------Sewer F-
-~-9?~----PIbg. Fees
.#,G'$£'Total
Date
----------------------------Eina1 OK
In the performance of this work the undersigned owner (or his suthorlzed agent) of said premises and his authorized Plumber hereby agree to be bounden by end
submit to all statutes, city ordinances, and rules and regulations prescribed by Ihe Board of Public Wo,ks for Ihe government of Plumbers.
II Is fulher agreed by Ihe undersigned Ihat no other uses will be made of the above connectionse~ept as hereinafter lisled.
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PlumbIng 'oopo<\O'