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PLUMBING PERMIT - Oshkosh, Wisconsin Permit Nr: 8672
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Lot),,"o. I Block I Ward I Addition or Replat
OUTSIDE WORK
Dale
NEW SEWn WAUl STORMS FEES FEES RElAY S- SE"". WAUl STORMS FEES
From MaIn 10 Curb Septic Tanks From Main 10 Curb
FIom Curb to Building Elecuic Pumps From Curb 10 Building
Repair
INSIDE WORK
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NO. NEW REP. usm ,... NO. NEW "P. USE. ...S NEW REP. USE. FEES
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Bath Tub Gubage DisponJs Cùcb Basins
Wuh Bum Dishwashen Conduclors
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Wal. ClORe! Laund>amùI Gre..... Catch BUÙUI
Slilk Waler Softeners Sump Pump Be Ejeclors
Wùø Heaters / /VC Sani1ary Bubblers Bar and Soda Wasles
Show... BùhR UriDaJs
Floor Drllhul Denial Cuspidors
Laundry Tubs Service Sinks
IlIIpectiou : !E.:~:~;~:~~:_~~~~:- ~:~~:: Fee Verified. Receipled and Recorded Received Permit and Iupeellon Fees
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-------- ----------------IDaide --_/..:....:- ----PIbg. Fees
$_00______-------------------------------------------- -----/~!12.._- Total
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In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorizad Plumber hereby agree to be bounden by and
submit to all statutes, city ordinances. and rules and regulations prescribed ~ Ihe Board of Public Works for the govornmenl of Piumbers.
It Is futher agreed by the undersigned that no other uses will be made of Ihe abovo connections except as hereinafter listed.
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Plumbtng 1.._,
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