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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 9151
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I Block I Ward
v
[ Lot No.
I Addilion or Replat
Date
OUTSIDE WORK
NOW SEwn WA1ER S10RMS fEES fEES RELAY S. SEWER WAn. S10RMS FEES
From Main 10 Curb Seplic Tanks From Main 10 Curb
From Curb 10 BuUcI1ng LL"/7,' /"~ .~ Eleclric Pumps From Curb 10 Builcling
Repair
INSIDE WORK
NO.
NEW
u..
HIS I NO.
NEW
.... I USED
NO.
NEW
FEES
....
USED
fEES
USED
BathTub
Garbage Dilpoea1a
Catcb BuiDII
Wub Buin
Dilbwuhen
Conduclor.
Water CIONI
Laundramatll
Gre... Catch Bulna
I--
Sink
Water Softeners
Sump Pump 8< Ejeclors
--
Water Heaters
sanUuy Bubblers
UriDa1a
Bar and Soda Wasles
Shower Batb8
Floor Dralaa
Denial Cuspidors
LaUDdr)' Tubs
Inspections
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Service Sinks
Fee Verified. Receipled and Recorded
Received Permil and Inspeclion F...
------~-'--~____Sewer Fees
_:_:.::~:~::~::; Fee.
Date ¿I- /'/. 76
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Valualion of Ihe Work Herein Described
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$
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City "....,.,
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In the performonco of this work tho undersigned owner (or his outhorired agent) of said premis.. and his authorized Plumber hereby agree to bo bounden by ond
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 egreed by the undersigned that no other uses will be made of the above connections except as hereinoftor listed.
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