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PLUMBING PERMIT - Oshkosh, Wisconsin Perml! N<:' 791
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Dale I Lot No. l Block I Ward ~ I Addition or Replat
OUTSIDE WORK
HIW SEWn WAtER STORMS FEES FEES RELAV S. SEWER WATER STORMS FEES
From MaIn to CW'b Septic Tanks From Main to Curb
From CW'b to Dundin; ,1/-/';'7/. )"6 ¡f.t/O Electric Pumps From CW'b to Building
Repair
Received Permit and Inspection Fees
mm<,3~'n~mSewer Fees
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INSIDE WORK
NO.
HIW
UP.
HO.
HEW
REP. I USED
FEES
NO.
USED
FlES
Bath Tub
Gubage Dispooals
Catch Bulm
Wuh Buin
Dishwuhers
Conductora
Waler Clooet
Laundramalll
Greue Calch Buins
Sink
Waler Softeners
Sump Pump Ik Ejectora
Waler Healen
Sanllary Bubblera
Bill' and Soda Wast..
Shower BaIhs
Urinals
Floor Dr8lu
Laundry Tubs
Dental Cuspidon
Service Sinks
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Valuation of the VJ:'è!t Herein Described
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Fee Verified, Receipted and Recorded
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City T,...".,
.
Date
HEW
REP.
FEES
USED
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In thl. Mr'for;"a~ce of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be boundan by ond
submit to all statutes, city ordinanc.., and rules and regulations prescribed by the Board of Public Works for tho government of Plumbers.
It Is futhar agreed by the undersigned that no other uses will ba made of the above connections except as hereinafter listed.
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