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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N<; 40
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I L<>I No. I Block I Ward
OUTSIDE WORK
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¡ Addition or Replat
Date
NEW SEWn WAtER STORMS fEES FEES RELAY So SEWER WATER STORMS FEES
From MaIn 10 Curb Seplic Tanks From Main 10 Curb
From C1øb 10 Building Eleclric Pumps From Curb 10 Building j// C. of' OJ,,;)!)
Repair
INSIDE WORK
NO. NEW UPo USEII FlES NOo NEW REPo USED fEES NOo NEW REPo USED fEES
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BaIh Tub Garbage Diaponk Celeb BulDo
Wuh Buin Dlshwuhen - Conduclors
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Water CI_1 Laundramaltl Greue Catch BuinR
-
Sink Water Sofleners Sump Pump 8< Ejeclors
Wllt8r H8IIIe.. Sanitary Bubblers Bar and Soda Wasles
Shower Baths Urina1o
Floor Dr8inll Dental Cuspldo..
- - -
Laundry Tubs Service Sinko
Impectiom ~;I~ Eoo~o:; ~:~: _::~::o::::o=: Fee Verified. Receipled and Recorded Receiyed Permit and Inspection FOOl
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In the performs nee of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by and
submit to all statutes, city ordinences, 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 connec!!j)~s except a~hereina!ter listed.
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