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PLUMBING PERMIT - Oshkosh, Wisconsin
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I Block I Ward
Permil N? 9994
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¡ Loi Ho.
l Addilion or Replal
Dale
OUTSIDE WORK
NOW SEwn WA"R STORMS fEES FEES REtAY S- SEWER WA"R STORMS fEES
From MaIn 10 c....b Seplic TRnks From Main 10 Curb
FJom C....b 10 Building Eleclric Pumps From C....b 10 Building
Repair
Received Permi! and Inspecllon Fe..
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INSIDE WORK
NO.
NEW
RE'.
FEES
NEW
REP. I USED
FEES
NEW
NO.
USED
NO.
IIaIh Tub
Garbage Dilponla
Calch Basins
1-
Wash Basin
Dishwashers
CDnduclon
III-
I? <X
Grease Caleh Basins
Waler CION!
Laundr-
1/
SlIIk
Waler SDflenen
Sump Pump" EieclDn
Water Healen
7
Sanilary Bubblen
Bar and Soda Wasles
!Jx
Shower Balha
UriDals
FloDr Dralu
Laundry TubR
J
/ A£:¡
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Denial CuspidDn
Service Sinks
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»,ualiDn of Ihe Work Herein Described
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Fee Verified. Receipled and Recorded
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In the ";rl~rmance of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agrea to be bounden by and
submit to all statutes, city ordinances, and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other uses will be made of the above connections except as hereinanar listed.
REP.
USED
FEES
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