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PLUMBING PERMIT - ~shkosh, Wisconsin Permit. N~ 1385 ~
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I LC>! Bo. I Block I Ward --_J Addition or Replat
Date
OUTSIDE WORK
NEW SlWEI WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn to Curb Septic Tanks From Main to Curb
FIom Curb to Dundlng ./ ;../' ~ Eleclric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
USEII
NO.
NEW
REP. I USE.
FEES
NEW
FEES
.EP.
USE.
NO.
REP.
FRES
Batb Tub
Gørbage DlçoIalI
Catch BaslDs
f----
Wash BaslD
Dishwashen
Conductors
WatN Cl0R8t
LaundramatR
Gre... Catch BaslDs
~
SIDk
Water Softeners
Sump Pump II< Ejectors
Water Heate..
Saniløry Bubblers
Bør and Soda Wastes
ShOWN Baths
Urinals
F1oo1' Dralu
Dental Cuspidors
Laundry Tubs
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Senice SlDb
Receiv~d Permit and Inspection FOOl
.......';:;...99.....s.wer FOOl
........lL~....P1bg. Fees
D~~:..~..~..T;;Y
In the performance of thi. work the unda..igned owner (or hi. authorized agent) of $Oid premi.es and his authorized Plumber hereby ag ee to be bounden by and
submit to all statules. city ordinances. and rules and regulations prescribed by the Soard of Public Works for the government of Plumbe...
It i. futher agreed by the undJJ<slgned that no other use. will ba made of the above connections except a. hareinafter listed.
Fee Verified. Receipted and Recorded
Valuation of the Work HerelD Described
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