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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N<:' 8678
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L~~LNO'n I Block I Ward
OUTSIDE WORK
LAciòition or Replat
Date
NEW SEW" WATER STORMS fEES "OS RElAY S. SEWER WATER STORMS FEES
From MaID to Curb Seplic Tanks From Main 10 Curb
!\rom Cub to Building Electric Pumps From Curb to Buil<llilg
Repair
INSIDE WORK
110. NEW REP. USED RES NO. NOW .". uSED fEES NO. NEW REP. USED FEES
Batb Tub Garbage Dlopooals Catch Bums
7 . 'Þ' ()O -
Wub Built Dishwuh.... Conduclors
1- - - - -
Water Closet Laundr- Grease Catch lIui1tl
SbIk Water Softeners Sump Pump 8< Ejectors
Water Heate.. So.niiary Bubble.. Bar and Soda Wastes
Shower Baths Urinale
Fl- DraWl Dental Cuspidors
Laundry Tubs Servloe Sinks
Inspections &;j:_:;p:~~:..:: ~::_~:~=:~ Foe Verified. Receipted and Recorded Received Permit and Inspec:lion Fees
-----.-- ---... ----OutsIde .--...-.....--..-....8ewer Fees
-...--.-----...---.---Inslde ;,f.LL.Q.f1.__PIbg, Fees
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In Ih.. performlnce of Ihis work Ihe undersigned owner (or his aulharbed a9"nt) of said premises and his authorized Plumber he.aby Igree 10 be bovnden by and
submil to III slatutes, city ordinances, and rules and regulalions prescribed by the 8"ard of Public Works for the government of Plumbers.
It Is futher 8greed by the undersigned that no other uses will be made of the above connections except .s hereinafte. lisled.
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PlumbIng In.""'"
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