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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N~ 9384
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I Lot No. I Block I Ward I Addition or Replal
OUTSIDE WORK
Date
NEW SEWEI WAUR STORMS 'EEl "'S RELAY S. SEWER WAUR STORMS FEES
From MaIn to Curb Seplic Tanks From Main 10 Curb
From Curb to BuDding Electric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO. NEW UP. USED .... NO. NEW REP. USE. "'S NO. NEW REP. USI. FEES
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Bath Tub Garbage Diapooa!s Catch BuiDs
Wuh BulD Diahwuhen Conduclors
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Water Cloeet Laund..ma.ls Greue Catch Bulwo
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Sink / Water Softeners Sump Pump II< Ejeclors
Water Heaten Sanitary Bubblers Bar and Soda Wasles
Shower Bathl UriDa.ls
Floor Drains Denial Cuspidors
Leunc!sy Tubo Serrice SIDka
Inspections Valuation of Ihe Work HerelD Described Fee Verified. Receipled and Recorded Received Permil and Inspecllon F...
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In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorized 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 lor the government 01 Plumbers.
It is luther agreed by the undersigned that no other uses will be made 01 the above connections except as hereinaltor listed.
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