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PLUMBING PERMIT -Oshkosh, Wisconsin Permit N<? ~
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I Lot No. I Block I Ward --_J Addition or Replat
OUTSIDE WORK
Data
Naw SEwn WATER STORMS fEES fEES RELAY S. SEWER WATER STORMS FEES
From M8III to Curb Septic Tanks From Main 10 Curb
FIom Curb to Builc11ng Eleclric Pumps From Curb 10 Building
Repair / ).oV
INSIDE WORK
NO. NEW RIP. UIID flES NO. NEW REP. USED fEES NO. NEW REP. USED fEES
- - -
Batb Tub G81'bage Dioponlo Catch Buins
f---
Wub Buin Diohwuhen Conductors
- - - - -
Water CIOl8t LaundrlUDllU Graue Catch Buins
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Sink Water Softeners Sump Pump 8< Ejeclors
Water Heate.. Sanitary Bubblers B81' and Soda Wasles
Shower Baths Urinals -
Floor Drains Denial Cuspidors
Laundry Tubo Service Sinks
Inspections Valuation of Ihe Work Herein Described Fee Verified. Receipled and Recorded Received Permit and Inspection Fees
..-.......-....---................-...---_......Ouilide $--/lt¿ß:..~............_..--.._..--..............- ........-...................Sewer Fees
~==:=:=m.i!i;?..:=::::::~~d~ ...../..~---..Plbg. F..s
$...........................................--............................. ..... ...1,...~.....Tolal
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__..m.....__--.m..--..--~1na1 OK $...................................................................----... Date 3./t.. --; <;..
In the pnformance of this work the undersigned owner (or his authorized agent) of said premises and his author ired Plumber hereby agree 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 luther agreed by the undersigned that no other uses will be made of the above connections except as hereinaller listed.
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