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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 135
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I Lot No. I Ward I Addition or Replat
OUTSIDE WORK
Date
NEW SEW" WAT" STORMS fEES FEES RELAY S. SEW'R WATER STORMS FEES
From M8In 10 C...b Septic Tanks From Main 10 Curb
FIom C...b 10 Building Electric Pumps From C...b 10 Building
Repair
INSIDE WORK
NO. NEW UP. USED HES NO. NEW REP. USED FEES NO. NEW REP. USEO fEES
~ ~ -
Bath Tub Garbage DiIpooaIo Catch Bolns
-
Wub BolD Dishwobers Conduclo"
~ - - -
Water Cl_1 LaundrlUDllÙ Greua Cateb BolDs
-
S1Dk Water Softene.. Sump Pump 8c Ejecto..
Water Heaters Sanitary Bubblers Bar and Soda Wot..
Shower Baths UrlDa1s ÍlJn~)~o I j.1YÒ
Floor Dr8lDs Dental Cuspidors
Laundry Tub8 Service SlDks
IDlpecI1ons Valuation of tbe Work Herein Described Fee Verified, Receipled and Recorded Received Permit and Inspecllon Fees
------m....-----------.-----------------._----Oulslde $---_'1_~_:--~..._...---------------..._-------_..._---------- -------------...--...--.----Sewer F-
-----------------------------------------------------lDIide _...j_:---~--...Plbg. Fees
$.........-----......-------....--......-------...---......--...------------ --...---/:-__":12---Tolal
--------------__--__m-----'------------"'------ --"'--'------------------Clïÿ---¡;.~~~;.;-------"'--------------'
--~---_.---_......_----ElDal OK $-----...------------...------------......---------------------...------- Dale -1- /$".71
In the performance 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 ell statutes, city ordinance., and rules and regulation. prescribed by the ØCNIrd 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 hereinaltar listed.
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