HomeMy WebLinkAbout0009165-Plumbing (interior & laterals)
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PLUMBING PERMIT¿ZZ::;° hkosh, Wisconsin Permit N<,; 9165
. . 'l' Name, Slreet - cÝ~ . ~S c
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I Lot No. ~ 1 Ward ___l Addition or Replai
OUTSIDE WORK
Date
N8W SEWD WAUR STORMS 'EES FEES RELAY S, SEWER WATER STORMS FEES
From M.du Iv c,..¡, ." í. Septic Tanks From Main to Curb
h>m Curb 10 BuUdIog .;J/I I;/¡Q¡ ç ~/ ð?) Electric Pumps From Curb to Buildlog
7 Repair
INSIDE WORK
NO,
NEW
UP,
NO,
NEW
REP, I USE.
NO,
NEW
FEES
REP,
USE.
FEES
USED
FlES
Batb Tub
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3...
3
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Catch BasÜ1l
Wub Basin
Dishwashers
Conducton
Gre... Catch BulI1a
Loundramats
Watu CIONt
Sink
Water Softenen
Sump Pump II< Ejeclon
.2..
Water Heate..
Sanitary Bubblen
Bar and Sodo Wast..
Sbowu Baths
UriDo!s
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Service Sinks
Floor Drelu
Dento! Cuspidon
Laundry Tubs
Fee Verified. Receipted and Recorded
Rec'J Permit and Inspection Fees
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tt'.2LL..f'¿l:f!.Total
Date -</-02:2- /C;
Valuation of the Work Herein Described
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City T,.nu,.,
In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby ogree to loa 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 mode of the above connections except as hereinafter listed.
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