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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N? 8866
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1- Lot :11'0. I Block I Ward I Addiilon or Replat
OUTSIDE WORK
Date
Naw SEW¡¡a WATER STORMS fEES fE.. RELAY S. "W" WATER STORMS fEES
From MaIn to Curb Seplic Tanks From Mmin '0 Curb
........ Curb to Building Blec"'!c Pumps From Curb to Building
Repair
INSIDE WORK
NO. Naw RIP. USED fE'S NO. NEW REP. USED FE" lio. NEW REP. USED fEES
Bath Tub Garbage DIspoøalo Catch Basins
Wuh Basin Dilh",...h... Conduclors
f---- - - - -
Water Cl_t Lauwlramllis Gr....... Catch Basins
Sink l/tKJ Water Softe".r. Sump Pump I!r: Ejecto..
Water Heate"" Sanliuy Bubble.. Bor and Seda W...tes
Show... Baths Urinals
Floor Dr""'" Denial Cuspldo""
Laundry Tubs Sem.. SIuko
IlIIpOCtloUl Valuation of the Work Herein Described Fee Verified. Recelpled and Recorded Received Permit and Inspectlo" Fees
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.....-.-------------wlde ....----L.-----Plbg, Fee.
--------.---.---- $-.------.--------------------------------- -----L-~--..Total
-----__----FIual OK $--.------...-------------------- --"'---------------c,;Y-ÿ;.-;-õ';;õ,""-------- Date /02-c2 9- )~
In the performance of Ihis work the undersigned owner (or his authorized ogenl) of ,oid premises and his authorized Plumber hereby agree to be bounden by IU1d
submit to all slatutes, oily ordinances, and rules and regulations presoribe" by the Beard of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other uses will be mode of the "boye <onnedions except .s hereinaller listed.
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