HomeMy WebLinkAbout0001630 P
f\
~
(~)
H-
ot
Plumber
4.... ¿. ~. PLUMBING P~IT - 0. hkosh, Wisconsin \/
" Name 12 Permll N? 1630 6
, " ;2,.. ,- J. . of . Slreet
- .--iÆi......................-- Owner -.- .-#r... ..W~-_........_.._- --.-...- N~:ber .
I ~.. 1- . _._.~ (:;7d6i9¿¡;¡;:;'.~~ .
c I Ward I. Addilion or Replat
OUTSIDE WORK
1:7
Date
NEW SEWEI WATER STORMS fEES fEES RELAY S. SEWER WATER STORMS FEES
From MaIn to Curb Septic Tanks From Main 10 Curb
From Curb ta BuDding r/ V ~ Eleclric Pumps From Curb to BuUdlng
Repair
INSIDE WORK
NO.
NEW
UP.
fEES
fEES
NO.
NO.
NEW
REP. I USEO
NEW
REP.
USED
USED
FI.,
Batb Tub
Garbage DiApoaals
Catch Bulu
Wuh BuiD
DiAhwuhen
Conductors
Water CI_t
Laundr-
Gre... Caleb BuiDo
r-
Sink
Water Softeners
Sump Pump Ik Ejectors
Watar Heaters
Sanitary Bubblers
Bar and Soda Wules
Shower BaIhs
Urinals
Floor DraiDs
Denial Cuspidors
[~-
Laundry Tubs
Il1Ipedlol1l
--..--. - - ..----- .--.. --- -.. -..-.. -Outside
.........-...---....----........--..........-Inslde
Service Staks
:a~~r.~..:::::.::~=-=:
~
Received Permll and Inspecllon Fe..
._-¿.~__Sewer Fees
._j.~'~___Plbg;7F"S
_._~-_~_....Tolal
Dale I ó/.;...h
Fee Verified. Receipled and Recorded
---'?-#&þ?~=:=;~-~;
'--""-"--"'-'---..----.-..----.
s
City T,.."",
In the performance of thi. work the unde..igned owner (or his authorized agent) of said premise. and his authorized Plumber hereby agróe to be bounden by and
submit to all statutes, city ordinances, and rules and regulations prescribed by the Board of Public Works for the government of Plumbe...
e undersigned that no other uses will be made of the above connections except a. hereinanor Ii.ted.