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/ì . .. \.. / / . / . PLUMB;V PERMIT - Oshkosh, Wisconsin . Permit N? 9570
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I Lot No. I Block I Ward I Addüion or Replat
OUTSIDE WORK
Date
NIW SEW" WAnR STORMS FEES FEES RElAY S. SEWER WAnR STORMS FE..
From MaIn to Curb ;-/. " ¡1/ /" <2 ~rCj Seplic Tanks From Main to Curb
~ Curb to Building Eleclric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO.
NEW
REP.
NO.
NEW
REP. I USED
NEW
fEES
REP.
USED
FEES
NO.
USED
FE"
Bath Tub
Garbage DÏI~
Catch BulnR
I------
Wash Buln
Dlsbwubon
Conductoro
WIIi.. CIONt
Laundromato
Gre... Cllicb Buina
f--
Sink
Wilier Softenero
Sump Pump" Ejectoro
Water Hellie..
Sanitary Bubblers
Bar and Soda Waslas
Shower Baths
Urinals
Floor Drabuo
Dental Cuspidors
Laundry Tubs
~:~:_-----------_.._--_.--._-_.____Outside
Service Sinks
Fee Verified, Receipted and Recorded
Received Permit and Inspection F...
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-------------,--------.-----Sewer Fees
----------/..."="'---PIbg, F...
._..__..-'I-,--~-.Total
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Valualion of Ibe Work Herein Described
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..---..--------.....---.----------.---.----------..-.--Inaide
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----
-------- ------Òiÿ-T;.;;~'.;;------------"----'------'
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In tho porformonce of this work tho undersigned owner (or his authorbed agont) of said premises and his authorired Plumber hereby agree to be bounden by and
.ubmit 10 all statutes, city ordinances, and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
It Is luther agreed by the undersigned that no other uses will be made of the above connections except as hereinafter listed.
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