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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 9212
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I Lol No. -I Block I Ward I Addilion or Replat
OUTSIDE WORK
Date
NEW SEW" WATER sTORMs FEEs FEEs RElAY S- SEWER WATER STORMS feES
From MaID to Curb h///-," W~ Seplic Tanks From Main 10 Curb
17 Iv ....
From Curb to BuDdlng Electric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO.
NEW
REP-
USED
FlES
NO.
NEW
REP. I USED
FEES
"°.
NEW
REP. I USED
fEES
Wuh Basin
1-
W
I7a
~
Garbage DÙlposals
Dishwasbers
Catcb Basins
Batb Tub
Conduclo"
If"
?'.M
Wat.. CI_t
Laundramats
Gre... Catch Basins
f-
SIDlo:
Water Softene..
Sump Pump" Ejeclors
Water Heate..
/
,60
sanUary Bubble..
Urinals
1.
/
~
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Bar and Soda Wasles
Sho.... Bathl
Floor Drelu
If'
'l".ðO
Dental Cuspido..
Laundry Tub8
Service Sinks
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Valualion 01 the Work Herein Described
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Fee Verified. Receipled and Recorded
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Received Permit and Inspecllon Fees
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-----.,l-¿:.:r~PIbg. Fee.
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Dale ~-61
In the performance of this work the undarsigned owner (or his authorired agent) of said premises and his authorized Plumber hereby agree 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 Plumbers.
It Is futher agreed by the undersigned that no other uses will be made of the above connections except as
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