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PLUMBING PERMIT - Oshkosh, Wisconsin ';er::it N<.? 346
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Dale ~
I Lot No.
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I Ward
¡ Addition or Replal
OUTSIDE WORK
NEW SEwn WAT" STORMS FEES fEES RELAV S. SEWER WATER STORMS FEES
From MaIn 10 Cwb Septic Tanks From Main 10 Curb
From Cwb to BuDding Electric Pumpo From Curb 10 Building
Repair
INSIDE WORK
NO. NEW UP. USEII FlES NO. NEW REP. USED FEES NO. NEW REP. USED FEES
- - - -
IIaIh Tub Garbage D1a~ - Caleb Bu1ns
- - -
Wuh BuiD Dlshwuhen Conductors
:- - - - -
Waler Closet Laundramall Greue Calch Bu1ns
-
..L BIDk V J,ðV Waler Softeners Sump Pump 8r: Ejeclors
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Waler Healers Sanitary Bubblers Bar and Soda Wules
Shower Baths UriDaIs
Floor Doallls Denial Cuspidors
Laundry Tubs Service Sinks
Inspecllons Valuatio~ o~~ Work Herein Described Fee Verified. Receipled and Recorded Received Permit and Inspecllon Fees
--Z;t""f/¡""';Z......._.......Ou~ide $m...7~~..:.........................................................- ..........................Sewer Fees
..o. .........,... .....7. ..-7..';Z...........Jnslde j,...t?q.......plbg. Fees
--.-.....ií. .'!l/-7...-:1.-.- ...........- .o-."" $........................................................................-.. .....................o.oTolal
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In the porlormence of this work the undersigned owner (or his authorized agent) of said premises end his authorized Plumber hereby agree to be bounden by end
submit to ell statutes, city ordinances, and rules and regulations prescribed by the Soord of Public Works for the government of Plumbers.
It Is futher egreed by the undersigned that no other uses will be made of the above connections except as hereinafter listed.
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STATE OF WISCONSIN)
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\Name¡
WINNEBAGO COUNTY
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\Address
being first duly sworn on oath deposes and says that he is not
a licensed plumber and that he has applied for a plumbing
permit to +he ng Inspector of the City of Oshkosh, to do
plumbing work in a owned and occupied by him, or a home
that is being constructed that is owned by him, and which will
be occupieÔ by him his home when completed. That he is not
building said home the purpose of sale.
This affidavit is made for the purpose of complying with
the provisions of the plumbing oode of the City of Oshkosh and
the State of ~iscon5in, which provides that all plumbing work
must be done by a licensed plumber exoept that the plumbing work
may be done by O¡,é? vho owns and occupies his own home providing
the installation coæplies with the plumbing oode of the City of
Oshkosh and the State of Wisconsin.
This affiant understands that the Plumbing work authorized
by the permit applied for, must be done only by this affiant and
that he cannot mnploy others who are not licensed plumbers to
assist with the work.
Dated this --.r:?2- day of ~~----------, 19...:?2-.
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Subscribed and sworn to before me
this .-d2 day ~----' 1922...
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Ñitfiy Public, Winnebago County, Wisconsin
MY COMMISSION EXPIRES
My Commission Expires g--~.':.~'::.~.:~------