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PLUMBING PERMIT - OSjhl Wisconsin Parmi! N<; 317
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Lot No. Block Ward --- Addi!ion or Replat
OUTSIDE WORK
Date
NEW SEwn WATn STORMS fEES fEES RELAY S. SEWER WATER STORMS FEES
From MaIn to Curb Seplic Tanks From Main to Curb
From Curb to Building Eleclric Pumps From Curb to Building
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INSIDE WORK
NO.
NEW
"P.
NO.
NEW
REP. I USE.
'EES
NEW
'E"
REP.
USE.
"O.
USED
"ES
Bath Tub
Garbage DIo~
Catch BuinR
Wash Buin
Dlobwuhers
Conduclors
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Water CI_t
Laundram&t8
Graase Catch Bulns
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Sink
Water Soften...
Sump Pump III: Ejecto..
Water Heate..
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Sanitary Bubblers
Bar and Soda Wasl.s
Shower Baths
Urinals
Floor Drains
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Dental Cuspido..
Leunclzy Tube
Service Sinks
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Inapeettons Valualion of Ihe Work Herein Described Fee Verified. Receipted and Recorded Received Parmi! and Inspection Feel
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In the performance of this work the undersigned owner (or hi. authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by and
submit to all statutes, city ordinances, and rules and regulalions 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 hereinafter listed.
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