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PLUMBING PERMIT - Oshkosh, Wisconsin P.rmil N? 9761
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I Lot No, I Block I Ward ----.I Addition or Replat
OUTSIDE WORK
Date
NEW SlWEa WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaID to Curb Septic Tanks From Main to Curb /
FJom Curb to BuDding Eleclzic Pumps From Curb to Building t/ P( 1-. ()fQ
Repair
INSIDE WORK
NO.
NEW
REP.
NO.
NEW
FEES
FEES
NO.
NEW
REP.
USiD
REP. I USED
USED
FEES
Beth Tub
Garbage Diopooals
Diohwashen
Catch Basins
Wuh Basin
Conducto..
Water CI_I
LaundramatR
Grease Catch Basins
f--
SIDk
Water Soften...
Sump Pump 8< Ejectors
Water Heaters
sanUary Bubble..
Bar and Soda Wastes
f
Shower Baths
Urinals
Floor Dralm
Dental Cuspidors
Service Sinks
if!fr: f Q?- ::r: --=:~: :_: :::.::
Leundry Tubs
Jupections
---------------------------------.----_----Oulside
-----------------------------------------------Inside
----------- ---------þ------------------------- I $--- ---------------------------.-------------------------------- I
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Fee Verified. Receipted and Recorded
Received Permil and InspectIon Feet
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--p/:--Q.Q--.--Total
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Date
Iin the Performance of this work the undersigned owner (or his authorized agent) of said premises end his authorized Plumber hereby egree to be bounden by end
submit to all statutes. city ordinances. and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
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