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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 960
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I Lot Jlo. I Block I Ward
OUTSIDE WORK
I Addition or Replal
Data
NIW SEwn WATER STORMo FEES FEES RELAY S. SEWER WATER STORMS FE"
From MaID to C\I1'b V".. Septic Tanks From Main 10 Curb
From C\I1'b 10 BuUdlng /' Eleclric Pumps From C\I1'b 10 Building
Repair
INSIDE WORK
NO. NEW "P. USED FEES NO. NEW REP. USED FE" "0. NEW REP. USED FE'"
~ - -
BaIh Tub Gubage DÙlponla Calch BWns
- -
Wuh Basin Dishwashers Conduclors
- - -
Wat.. Cl_t Laundramals Greue Catch Bulns 1-:
SIDk Water Softeners Sump Pump Be Ejeclors
Waler Haata.. Sanitary Bubblers Bar and Soda Wules
Sho.... BaIha UriDa1s
noor Dra1D8 Denial Cuspidors :1
Laundry Tubs Service Sinks
Impactions Valuation of Ihe Work Herein Described Fee Verified. Receipled end Recorded Received Permit and Inspeclion Fees
-----------------------------------------_--_---OulBide $,f,fÓZ'------------------------------------------.- --_.Jcf'ß-------Sewer Fees
---------------------------------------------------Inside ----------._---------------Plbg. Faas
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In the performlnce of this work the undersigned owner (or his euthorbed 19ont) of seid premises Ind his luthorized Plumber hereby Igrle to lie ~nden by end
submit to III stltutes, city ordinlnces, end rules Ind reguletions prescribed by the øo;ord of Public Works for the government of Plumbers.
he undersigned thlt no other uses will bl made of the ebove connections e~~ept IS hereinlfter listed.
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