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PLUMBING PERMIT - Oshkosh, Wisconsin Permil N~ 1211 X
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I Block I Ward
I Lei Ho.
I Addilion or Repia!
Dale
OUTSIDE WORK
NEW SEW" WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaID 10 Curb Seplic Tanks From Main 10 Curb
Fmn Curb 10 BWldIng Eleclric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO.
UP.
USED
NEW
FIlS
NO.
NEW
REP. I USED
FEES
"O.
NEW
REP.
USED
FEES
I
1.
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I
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IIaIh Tub
Garbage DispooaJs
Calch Bulns
1,00
Wuh Basin
Dishwasben
Conduclors
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j,PV
/. 0lJ
¡'uV
Waler Cl_t
Laundramals
Gre.... Caleb Basins
I--
;/
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Sink
Wain Softeners
Sump Pump" Ejeclors
Waler Healers
Sanilary Bubblers
Bar and Soda Wasles
Shower IIaIbs
Urinals
H--+-+
nOO1' Drains
Denial Cuspidors
Laundry Tubs
Service Sinks
Inspeclions Valualion of Ibe Work Herein Described Fee Verified. Receipled and Recorded Received Permit and Inspeclion F...
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In the performance of this work the undersigned owner (or his authorized agent) of said premises end his authorized Plumber hereby °sree to be bounden by ...d
submit to oil statutes, city ordinances, and rules and regulations prescribed by the Boord of Public Works for the government of Plumbers.
Iy the undersigned that no other uses will be made of the above connections excepYÚ)hOl<.nafter listed.
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