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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 9998
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I Block I Ward
H-
of
Plumber
l Lot Ho.
I AddUion or Replat.
Dde
OUTSIDE WORK
o.
NEW SEWEt WAIER srORMS FEES FEES RELAY S. SEWER WAIER STORMS FEES
From MaiD to Curb Septic Tanks From Main to Curb
hom Curb to BoUding 1f~1 if¡ ~J' ~ flj;OO Electric Pumps From Curb to Building
Repair
Receiv~ ðëJmit and lnspecllon Fees
......,.¿'~m............Sewer Fees
......,...?69ðPlbg. Feel
-JI'....f-p.UL.Total
Date bl. /r;.. V /1):;
INSIDE WORK
NO.
NEW
RI,.
NO.
NEW
REP. I USE.
NO.
NEW
FEES
US"
FlES
Batb Tub
Garbage Dlopooalo
Catch Basins
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Wub Basin
Dlohwashen
Conducton
Wder C1oaet
Laundram8!l
Gre... Cdch BasiDI
Sial<
Water Softenen
Sump Pump 81: Ejecton
Water Heden
Sanilorr Bubblen
Bar and Soda Wastes
Shower Bathl
Urinals
Floor DraiDI
Laundry Tube
Dental Culpidon
Service Sinks
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Valuallon of the Work Herein Described
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Fee Verified. Receipted and Recorded
$.
$............................... .................-..............-....-
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In the performance of thi, work the undersigned owner (or his luthorired agent) of said prem!,es and hi, luthorired Plumber hereby Igre~ndln by ..,d
submit to III statut.., city ordinances, and rules and ..gulltion, p..,cribed by the Bolrd of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other uses will be mede of the above connections except as hereinafter listed.
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PI,mb<,
RIP.
USE.
FEE.
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