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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N!,;' 8423
/7 "--13 '7þ} Name C // ~ - Slreet ~
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I Lot N~ I Block I Ward I Addition or Replat
Date
OUTSIDE WORK
NEW SEWJ!II WAT" STORMS FEES FEES RELAY S, SEWER WATER STORMS FEES
From MaIn to Curb Septic Taw From Main 10 Curb
From ClØb SO SuUdIn" Electric PumPR From Curb 10 Building
Repair ~- ) /f--r/
INSIDE WORK
NO. NEW UP. US... FEES NO. N,W REP. U'ED FEE' NO. NEW REP. USED "ES
-
Batb Tub Garbage Diepooa1s ClÚch Baam.
Wuh Bum Dishwashers - Conductors
- -
Water CI_t Launc!ramabl On... ClÚch B..iIIa
SIB1i: Water Sofleners Sump Pump 8< Ejectors
WÛ6I' Reaten Sanitary Bubblers Bar and Soda W..les
Bhow... ,Buu UriDaIE
Floor Dra!D8 Denial Cuspidors
LellDdry Tubo Service Sinks
¡...pect1o... Valuation of the Work Herem Described Fee Verified. Receipled and Recorded Received Permit and ¡...pecnon F...
-_.------- ---------- ----OutRide $------L?2._t2.-,---~~------------------------, --------------Sewer Fees
.------------------------------wide --j~!.::::"P1bg. F...
$------------------------------------------------ ---_.l..:_--:~-::::!.-Total
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- _LL--__---FiDaI OK: $---------------------------------------------------------- Date 1..:2-=2 - 7...s .-../
In the performance of this work the undersigned owner (or his authori.ed agent) of said premises end his authorhed Plumber hereby agree to be bounden by and
submit to all statutes, city ordinances. and rules and regulations prescribed b~-"rd of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other uses will be mad. of the above connections except as hereinafter listed.
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