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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 21
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I Lot No.
I Addüion or Replat
~ I Ward
OUTSIDE WORK
Date
NEW SEW" WATER STORMS FEES FEES RELAY S- SEWER WATER STORMS FEES
From MaID to Curb Septic Tanks From Main to Curb
IWm Curb to BuUdIn" Electric Pump. From Curb to Building V
Repair fl"ðO
INSIDE WORK
NO.
NEW
NO-
FEES
NEW
REP- I USED
FEES
NO.
NEW
UP.
USED
FlES
REP.
USED
Bath Tub
Garbage D~
Catcb BulDs
Wuh Buin
Dishwuhers
Conduclors
Water CIONt
Laundramala
r---
Grease Catch BuIDs
SIDk
Water Softeners
Sump Pump 8i: Ejeclors
Water Heaters
Sanitary Bubblers
Bar end Soda Wules
Shower Balbi
UriDals
Floor ~aIDS
Laundry Tubo
Denial Cuspidors
Senice Sinks
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Valuaiion of the Work Herein Described
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Fee Verified. Receipled and Recorded
Received Permit and Inspection Fees
...h......h.......h......Sewer Fees
. /i:.kOÞ..........PIbg. Fees
l1'./,..?!D...........Tolal
Dale 01;;j~ '}7
$.
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City Tree..,e,
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In the performence of this work the undersigned owner (or his authorirad agent) of said prem!sas and his authorized Plumber hereby egree to be bounden by and
submit to all statutes, city ordinancas. 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 hereinafter listed.
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Plumbing Ino_, . ...
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