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PLUMBING PERMIT - Oshkosh, Wisconsin
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OUTSIDE WORK
PermU N'i? 5
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Street
and
Number --
I Addition or Replat
Date
NEW SEwn WAfER STORMS FEES FEES .EIAY S. SEWER WATE' STORMS FEIS
From MaIn to Curb Septic Tanks From Main to Curb
From Curb to BuDding Electric Pumps From Curb to Bulleting
Repair j/ 9'/&ò
INSIDE WORK
NO.
NEW
RIP.
NEW
.EP. I USEO
'EES
FEES
NO.
NEW
.EP.
USE.
USED
FIlS I NO.
Bath Tub
Garbage DiIpoIa1a
Catch Bulns
Wuh BulD
Dishwashen
Conductors
Water ClOl8t
LaundrlUl1lÙ8
Greue Catch Basins
+--
Sink
Water Softeners
Sump Pump Be Ejectors
Water Heaters
Sanitary Bubblers
Bar and Soda Wastes
Shower Baths
UriDa1a
Floor Dralu
Dental Cuspidors
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Laundry Tuba
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Service Sinks
Y.aluation of the Work HerelD Described
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Received PermU and Inspection Feee
u_--.-.-...--------....Sower Fees
---.j,,_J'.O-------_.Plbg, Fees
,!--./,dJil..----..Total
Date .:; /." ¿/,/r) 1]
Fee Verified, Receipted and Recorded
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City T",.....
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In the performlnce of this work the undersigned owner (or his authorized agant) of .ald premises and his authori.ed Plumber hereby agree to 'be bounden by and
submit to all stltutas, city ordinances, and rules and regulations prescribed by the BOard of Public Works for the government of Plumbers.
It i. futher agreed by the undersigned thlt no other uses will be made of the above connections except as hlreinlfter listed.
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