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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N? 8464
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LL_o1NO. I Block I Ward I AddUion or Replat
OUTSIDE WORK
Date
NIW SIWEI WA1E. STORMS FEES FEES .EIAY S. SEW'. WA1ER STORMS fEES
From MaIn 10 Curb Seplic Tanks From Main 10 Curb
~m Curb to BulIcIIDg Eleclric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO. NIW "',. USED "OS NO. NEW 'EP. USE. fE.. NO. NEW .E,. USE. FEES
Bath Tub Garbage Dilpooala Caicb Bullis
- -
Wash BulB Dishwashers Conductors
- - -
Wat.... Cloeel Laundrama.is Gre..... Calch BasIDs
SIDk Water Softeners Sump Pump 8< Ejeclors
Water Heat81'll / I'--c) Soniiary Buhblers Bar and Soda Wasles
SIIo- Baths Urinals
Floor DraIDa Denial Cuspidors
LaUDdrr Tubs Service Sinks
IIIIpect10Dl Valuation of Ihe Work Herein Described Fee Verified. Receipled and Recorded Received Permit and Inspection Fees
---.-------------. ------Outside $---.L.Þ2::..'!':!.___--------------------- -----.-----.-------Sewer Fees
-----~frfI-~ ;:--.--.-Imde $---.-..---.--.----..--.----------------------------- ---L~_plbg. Fees
---- ~ -------- -----J~-_:---__Tofal
--.-----------Final OK $------------------------------------------ ----------------------ëïtŸTr.a."ù;ë;--------------- Date iT /s-- 7"::'----'
In the performance of this work the undersigned owner (or hi. authorized agent) of .sid 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 for the government of Plumbors.
It Is futher agreed by the undersigned that no other uses will be made of the above connections except ss hereinslter listed.
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