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PLUMBING PERMIT - Oshkosh, Wisconsin . Permit Nr: Y37
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L~-'!O'-m- . . I Block I Ward I Addiiion or Replat
OUTSIDE WORK
Date
Naw SEW" WATER STORMS FEES FEES RElAY S. SEWER WATER STORMS FEES
From MaIn to Cub Septic Tanks From Main io Curb
From Cub to BuDding ß!.', ,/1..-' ¡"C. ~ Electric Pumps From Curb to BuUding
Repair
INSIDE WORK
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NO. NEW REP. USEO FlES No. NEW REP. USED FEE5 NO. NEW REP. USED FEES
Bath Tub GarbagG Dilpooak Catch Basi...
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Wuh Buin Dilh.....h.... Condudors
Wilier Clooet Laundr- Greue Catch Buins
SID!< Water Softeners Sump Pump 8< Ejectors
Water Heate.. Sanitary Bubblers 1- Bar and Soda Wutes
Show... BatIuo Urineil
~ Drelwl Dental Cuspidors
LallDdry Tuba Service Sinks
Impactions Valuation of the Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Impaction Fees
- ----------- ---Outside $m,,;1~~L~___.._-------------------_....- -------J-,-::~...sewer Fees
-----..----------------......IDIide -------L.~~_Plbg. Fee.
$....------...------..------------------..---.--- -------¥--.!.~-Tofal
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$ ...-.. ___m"__"- --- --.. -- -- Date /ó'd.-7 }...5-
In Ihe performance of this work the undersigned owner (or hi. authori.ed a9"nl) of .aid pr"ml.e. and his authori.ed Plumber h"roby agroo to be bounden by and
submit to oil statutos, city ordinancos. and rul... and regulations pr".cribed by Ihe 30ærd of Public Works for the .9Gvernmenl of Plumbers.
It is futher agreed by tho undersigned that no "thor use. will be made of Ihe .bove connection. excepi o. hereinallor lislad.
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