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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N<: 9571
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Dllio I Lot NO'" I Block I Ward I Addilion or Replat
OUTSIDE WORK
NEW SEWn WATER STORMS FEES FEES RELAY 5. SEWER WATE' STORMS fEES
Fzom MaIn to Curb Sepllc Tanks From Main to Curb
""'m Curb to Builellng Electric Pumps From Curb to BuUellng
Repair V--- ¡rd
INSIDE WORK
NO. - NEW REP. USED "'5 NO. NEW REP. USED fEES NO. NEW 'EP. USED fEES
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BathTub Garbage DiIpooaIs Caich Basills
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Wasb Basin Dishwashen - Conductors
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Wilier Cl_t LaundrllDl&is Grease Cllich Bullis
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SIn1o: Wilier Softeners Sump Pump" Ejectors
Wilier Hollie.. Sanitary Bubblers Bar and Soda Wastes
ShowerBaihs Urinals
Floor Drains Dental Cuspldo..
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Leundry Tub8 Service Sinko
Inspections Valuation of the Work Herein Described Fee Verified, Receipted and Recorded Received Permit and Inspection Fo..
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---------------.----------F1Da1 OK S----------.-------------.-----------------.------------------------------- -------------------------Cí¡:¡T~;;;-;;ë;-------------------------- Date '/-,,;2'2 7~
In the performance of this work the undersigned owner (or his authorized agent) of said premises and hi. authorired 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 for the government of Plumbers.
It is futher agreed by the undersigned that no other uses will be made of the above connections except as hereinafter listed.
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