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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 8234
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l<>L~"--___- -- I Block I Ward I Add;;;o" or Replat
OUTSIDE WORK
Dale
NEW SEWEll WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn 10 Curb Sepiic Tanks From. Main 10 Curb
From Curb to Building Electric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO. NEW u,. USED FlES NO. NEW REP. USED FEES NO. NEW REP. USED FEES
Bath Tub Gazbago Dispolalsl ClÚch Bums
Wub Buln Dlshwuhen - Conducto..
- -
Wale CICIOI LaUDdz- Grease Catch Bulns
SbIIr: Waler Soft"ne.. Sump Pump 8E Ejectora
Wmr Healen Saniluy Bubblen Baz and Soda Wastes
She- Bathl Urinals I~--/f: /J A7: LA
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n- DrIllDs Denial Cuspidon
Laundry Tuba Service Slab
IlIIpeciiolll Valualion of !he Work Herein Described Fee Verified, Receipted and Recorded Received Permi! and Inspection Fees
--------_._----_----OuÞlde $-------~;:¡:-~------------------------ ---------ti'il--_Sewer Fees
---------------- ----_IlIIide --/.-----PIbg, Fees
----------------.-- $----------------------------------------------- ---L~~------TOfal
-----------FIna1 OK $------------------------------------------------------ -----------------------ëii:¡--ÿ;ë;.ü;õ;----------------------- Date y- /'l- 75
In the pGrlormonce of this work the undersigned owner (or hi. authorized agent) of .aid premise. and hi. authorized Plumher hareby agree to be bounden by and
submit to all stotutos, city ordinances, and rules and regulations prescribed by Ihe Board of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned thai no other uses will be made ef Ihe above connections except as herein.flor Ii.ted.
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