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~~ PLUMBING PERMIT - Oshkosh, Wisconsin Permit N<? 1618 ¿
Ifame Name,. Street
of of and -
Plumber - -'- ..... ... n.n .... _n..............n Owner .n~...á).e¿I'-:""""""'-""""""'" Number ~.:3...~æ~.._.._-
I Lot No. I Block I Ward l Addition or Replat
OUTSIDE WORK
Date
Haw SEW" WATER STORMS FEES FEES R"AY S. SEWER WATER STORMS FEES
From MaIn to Curb Septic Tanks From Main to Curb
From Curb So BuUdh1¡ Electric Pumps From Curb to Building
Re~
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,
INSIDE WORK
NO.
HEW
UP.
NO.
NEW
FEES
FEES
NO.
NEW
REP.
USED
REP. I USED
USED
FlES
_Tub
Garbage Dispooa]s
Catch Basins
f---
Wuh Basin
Dishwashers
Conductors
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Water CI_t
Laundramats
Grease Catch Basins
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SIDk
Water Softeners
Sump Pump 8< Ejectors
Water Haaters
Sanitary Bubblers
Bar and Soda Wastes
Shower Baths
Urinals
Floor Dr81rul
Dental Cuspidors
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LeUlldry Tubs
Inspec!ions
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Service Sinks
Fee Verified. Receipted and Recorded
Received Permit and InspseUon Fees
......../.,.ðQ.nnSewer Fees
nn....................n..PIbg. Fees
D~~:.~~/;r
Valuation of the Work Herein Described
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." th. performance of this work the undersigned owner (or his authorized agent) of said premises end his authorized Plumber hereby agree to be bounden by and
submit to all statutes, city ordinences, and rule. and regulations prescribed by the Board of Public Works for the government of Plumbers.
nderslgned that no other uses will ba mede of the above connections except as hereinafter listed.
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