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PLUMBING PERMIT - Oshkosh, Wisconsin
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I L~ No. I Block I Ward
OUTSIDE WORK
Perml! N° I
-3, - . 9507,
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t- Adc1ition or Replat
Date
NEW IEWEI WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
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From MaIn to Curb g ¡J" Seplic Tank. From Main to Curb
From Curb to BuDding t/~/ (Ï" / Jfé:;.,- :70{) Elecuic Pumps From Curb to Building
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(/ ~ Repair
INSIDE WORK
NO.
RIP. I USED I flES I NO.
FEES
NEW
NEW
REP. I USED
FEES
NO.
NEW
REP.
USED
_Tub
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Garbage Disposals
Catch Basins
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I/~/
Wuh Basin
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Dishwashers
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Conduclorl
Wat... Cl_t
Laundramall
Grease Catch Basins
I--
Sink
Water Softenero
Sump Pump" Ejeclors
Water Heaten
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Bar and Soda Wasles
Shower Baths
Sanllary Bubblen
Urina!I
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Floor Dralu
Denial Cuspidon
Laundry Tubs
Service Sinko
Inspections Valuation of the Work Herein Described Fee Verified. Receipled and Recorded Received Perml! and Inspaellon Fe..
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In the performlnce of this work the undersigned owner (or his authorized agent) of said premises Ind his authorized Plumber hereby agree to be boundan by and
submit to all statutes. city ordinance.. and rules and regulations prescribed by the Boud of Public Works for the government of Plumbers.
It is futher agreed by the undersigned that no other u..s will be made of the above connections except os hereinafter listed.
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