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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 617
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I Lot No. I Block I Ward I Addilion or Replat
OUTSIDE WORK
Date
NEW SEWEa WATER STORMS FEES FEES RELAY So SEWER WATER STORMS FEES
From MaIn to Curb Seplic Tanks From Main 10 Curb
From Curb to BuDding ---- ..--- I cf, oV Eleclric Pumps From Curb to BuUding
Repair
INSIDE WORK
NOo
NEW
REPo
NOo
FEES
USED
FlES
NOo
NEW
REPo I USED
FEES
NEW
REPo
USED
_Tub
Garbage Diapooals
Catch BIIIÚ1I
Wuh Basin
Diabwashen
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Conduclorl
Water CI_t
LaundrllD1ai8
I--
Greua Catch Basi11ll
Sink
Water Softeners
Sump Pump I< Ejectorl
Waier Heaten
sanUary Bubblers
Bar and Soda Wasles
Shower Baih8
UriD81s
Floor Dralu
Denial Cuspidorl
Laundry Tubs
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Service Sinks
Valualion "Jife Work Herein Described
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I
Fee Verified, Receipled and Recorded
Received Permit and Inspection F...
---SJJILo__hoo_Sewer Fees
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City T,."".,
In th4 performance of this work the undersigned owner (or his authorized agent) of said premises and hi. authorized Plumber hereby/agree to bal,ounden by and
submit to all statutes, city ordinance., and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
II Is futher agreed by the undersigned that no other uses will be mede of the above connections except as hereinalter listed.
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