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PLUMBI~ PE~MIT - Oshkosh, Wisconsin permü/!r- ~~
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I Lot No. --.1 Block I Ward I Addilion or Replat
OUTSIDE WORK
Dale
NIW SEWEa WATER STORMS fEES FEES RE.",. S- SEWER WATER STORMS "ES
From Maln to Curb Septic Tanks From Main !o Curb
!'10m Curb to Building Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO. NEW UP. USED flES NO. NEW REP- USE. FEES NO, NEW REP. U$ED "ES
- - - -
BIdh Tub Gubage Disposals Ca!<:h BuI...
/ ;,-'-'0 -
WuIo Bum Disbwuhers C""ducJors
1- - -
Wat. CI_t I I/IKI La\lwama.ts Grease Catch BulDs
,
BIDk Water Softe"ers Sump Pump 8< Ejec!ors
Waler Heaten Sanituy Bubblers Bu and Soda Wastes
Bilow. B81ha Urinals
Floor Dralua Dental Cuspidors
Lalll1dry Tubs Service 5mb
IlIIpIIC!ions Valuation of the Work Herein Described Fee Verified. Receipted and Recorded Received Pormil and Inspection Fees
..--..-....- ----, -..-OUtside $ ..__~ÇX::L_?!:..__- ---'--"-"-----"""--- -------..-...........-Sewer Fees
-....-..---..-.....---..-------Imide ___d..~.._Plbg. Fees
-----..------------- $..---....-------...----..-------------------------- ....._:2.-._::::'!___Total .
------------Etnal OK $.-..------..-..-..---.---....---..---- ----------------""'-èiiÿYréüü;ë,"----"-""'----""" Date /1-c2 C¡.. 7S-
In the psñormance of this work the undersigned owner (or his authorized agent) 01 said premises and his authorized Plumber hereby agre. to be bounden by and
submit to all stalutes, city ordinances, and rules and regulations prescribed by the Boord of Public Works for the government 01 Plumbers.
. ,. "w .... :Ë .==~tha:_~O..::_::~_~:~=:II___~_:..::::__::_t:e abov ,e connections ~ as ~.r.in.:i.ted. .~ ~ (
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____n...."""'- ---..- AJ.J1P1umblng --- -,--- ----..- --~-------------_.._---