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PLUMBING PERMIT - Oshkosh, Wisconsin
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I Block I Ward
l LoJ No.
Date
OUTSIDE WORK
Permil
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Sireel
N~:ber _--./._6//:1--
9917
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I .Addition or Replal
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NIIW SEwn WATER STORMS fEES FEES RElAY S. SEWER WATER STORMS FEES
From MaIn 10 Curb Septic Taaks From Main 10 Curb
nom Curb 10 BuIlcllnll Electric Pumps From Curb 10 BuUcIlng Z
Repair
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INSIDE WORK
NO.
NEW
REP.
NO.
NEW
REP. I USEO
USED
FlES
BathTub
Garbage DÙlpoIa!a
Wuh Buin
DiJhwuhen
Water CIONI
Laundramall
Sink
Water Softeners
Wai8r Heaten
Sanitary Bubblers
Shower BaIhI
UrinaÜI
Floor Drllina
Denial Cuspidors
Laundry Tubs
Service Sinks
Fee Verified. Receipled and Recorded
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'Jration of Ihe W~rk Herein Described
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$------------------------------------------------------------------------
City T"""",
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FEES
NO.
FEES
NEW
REP.
USED
Ca!ch BulDs
Conduclors
Graue Catch BalDs
Sump Pump 8< Ejeclors
Bar and Soda Wales
Received Permi! and InspectIon Fees
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Dale ;)://0./22
In the performlnce of this work the undersigned owner (or his luthorlzed agent) of slid premises Ind his authorized Plumber hereby Igree to be bounden by and
submit to III stltutes. city ordinlnces. and rule. Ind regulltions prescribed by the Board of Public Work. for the government of Plumbers.
It Is fulher agreed by the undersigned thlt no other uses will be made of the above connection. except as hereinofter listed.
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Plwnblng Ino_."
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