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Date
PLUMBING PERMIT - Oshkosh, Wisconsin Permll N? 576
If- /} /J ¡J ¡) Name ~ ./ZJ. j! Streel. ,
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I Lo.I No. I Block I Ward 1- AddUlon or Replal
OUTSIDE WORK
NEW SEwn WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn 10 Curb Sepllc Tanks From Main 10 Curb
IWm Curb 10 BuDding 4 I"' 4oò Electric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO,
NEW
REP,
USED
flES
NO.
NEW
REP. I USED
FEES
NO.
NEW
REP, I USID
FEES
Bath Tub
Garbage DIo~
Catch BuiDs
Wub Buln
Dlobwuben
Conductors
Water C~t
Laundramail
Graue Catch Bulna
f--
Sink
Water Softeners
Sump Pump 8< Ejectors
Water Heaters
Sanllary Bubblers
Bar and Soda Wul..
Shower Baths
Urinals
noor Dr81n8
Denial Cuspidors
-~-
Laundry Tubs
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Senice Sinks
Valualion of Ibe Work Herein Described
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Fee Verified. Receipted and Recorded
Received Permit and Inspection F-
.n.3<.ßÞmmmSewer F...
m.h.~.nn.....PIbg. Fees
....~,tl.Zi...,..,...Total
Dale -yJÍz./77
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In' Ih/P;,.{ormsnce of Ihis work Ihe undersigned owner (or hi. aulhorized agenl) of .aid preml.e. and hi. aulhorlred Plumber hereby agree 10 be bóunden by ond
submll 10 all slalule., city ordinances, and rule. and regulalion. prescribed by Ihe Board of Public Works for Ihe governmenl of Plumber.,
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