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PLUMBING PERMIT - Oshkosh, Wisconsin Parmi! N': 8520
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I Lo.! Ifo. I Blook I Ward I Addilion or Replat
OUTSIDE WORK
Dala
NEW SEWEI WATER STORMS FEES FE" RElAY S. SEWER WATER STORMS FEES
From MaID 10 Curb Seplio Tanks From Main ~o Curb
!'10m C...b to Building 14"I'A - / II é'. ~ Eleotric Pumps From Curb 10 Building
Repair
INSIDE WORK
,
NO. NEW UP. USED FEES NO. NEW REP. USED FOES NO. NEW IEP. USED FEES
Bath Tub I /,nJ Garbage Diopoealø Caleh Bas!wl
1.:2.~ -
Wuh Basin / I Dishw..hen Conduclors
¡--- - - -
Wai8r CION! I I ;:¿y-.: Laundramats Greue Catch BasiDI
Slak Waler Softeners Sump Pump Be Eieelon
Water Kellle.. Sanitary Bubblers Bar and Soda Wasles
Show... Balbs / /vU Urinals
F1oo:r »ralwo / I;. tW Denial Cuspidors
Laundly Tubs Servioe Sinks
Iml~ -~ Valuation of the Work Herein Described Fee Verified. Receipled anel Recorded Received Permit aud Impaction Fees
-_... . . h ð ;f-...._.___._Ou~ide $-_/"-.r!../L~--------_._-----_...---- -_.---.$...,--~.-_Sewer Fees
----.. V};.--'7-'---_'__Wlde ._--_2?~.~_.PIbg. Fee.
----'i. 2~____._- $..---...----.-------.-.------.--------.---------...---- ----..LJ~--~~-Total
~----------_._---FiDa1 OK $----------------.--.--------------.----.-...-.---- '.-..'.'...'---------"Cï.ÿ-Tr...;;ë;--------'.-----"'- Dale 'is..2? 7S-
In the performance of this work the undersigned owner (or his authorired agent) of said premises and his authorized Plumber hereby agree to be bounden by and
submit to all statutes, city ordinances, and rul.. and regulations prescribed by Ihe Board of Public Works for the government "f Plumbers.
It Is futher agreed by the undersIgned that no other uses will be made of the abeve connections except as bereinafter listed.
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PlumbIng Ins_r--.D_,(3
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