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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N? 9901
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l Lot No.
Street
and
-.. Numbel
I Block I Ward
I Addition or Replat
Data
OUTSIDE WORK
NIW SEwn WATER STORMS FE" "'S RELAY S. SEWER WATER STORM' 'EE'
Main to Curb Seplic Tanks From Main to Curb
~=.;~,C\Øb SO Building Electric Pumps From Curb to Building
Repair
Received Permit and In,pecnon Fa..
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In Ihe psrformlnce of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by and
."bmlt 10 all statutes, city ordinances, and rules and regulations prescribed by the Board of Public Works for the government 01 Plumbers.
I It i, luther Igreed by the undersigned thlt no other uses will be madl 01 the Ibove connections except as hereinafter listed.
INSIDE WORK
NO.
NEW
..,. I USID tL
/
/
NO.
NEW
RE,. 1 USED
NO.
FEES
Bath Tub
-L
L.
/
Laundramatl
G.e... Catch Basins
Garbage DIs~
Catch Basins
Wash Basin
Dishwashers
Conducto..
Water CI_t
Sink
Water Softene..
Sump Pump II< Ejectors
1-
W-r Haate..
Sanitary Bubblers
Bar and Soda Wastes
ShOWM Baths
Urinals
Floor Dralu
Dantal Cuspidors
Laundry TubI
~:~.:_.........._...._.._.........Outside
Service Sinks
Valuation of the Work Herein Described
$... ...~4.~.~.~..<...ø...¡L......._-_._...........
.
Fee Verified. Receipled and Recorded
e
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City Tro,...or
NEW
REP.
USED
fEES
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