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PLUMBING PERMIT - Oshkosh, Wisconsin Permit N? 9573
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I Lot Ifo. I BlOCk' I Ward I Addition or Replat
OUTSIDE WORK
Date
NOW SEWEI WATE' STORMS 'EES 'EES 'ELAY S. 'EWE. WATER STORMS 'EES
From MaiD to Curb Septic Tanks From Main to Curb
From Curb 10 Building Eleclrlc Pumps From Curb 10 Building
Repair
INSIDE WORK
NO.
NEW
NO.
'EES
NEW
'EP. I USE.
FEES
"O.
RIP.
USED
FIlS
NEW
'EP.
USE.
Ba1b Tub
Garbage DlopooaIa
Catch Bulns
Wuh BaslD
Dlshwashen
Conduclors
Water CI_t
Laundramals
Grease Catch BasiDs
SiDII:
Water Softeners
Sump Pump" Ejectors
Water Heaten
Sanitary Bubblers
UrlDats
/Þ1 /' "V "
//$-5-12-
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Bar and Soda Wasles
Shower Baths
Floor Dr8ÌD8
Laundry Tuba
Dental Cuspidon
Service SlDb
Ins~ons --,___----Ou1side
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Valuation of the Work HerelD Described
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$ --.-- ---------------- -- - --------M_-------- ---- ---- -- -... -----,
Received Permit and Inspeclion Foeo
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Fee Verified. Receipted and Recorded
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------------.----------FlDal OK
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In the performance of this work Ihe undersigned owner (or his authorized agent) of said premls.s and his authorized Plumber hereby agr.. to ba bounden by and
.ubmlt 10 all statutes. city ordinance.. and rule. and regulations prescribed by the Board .oI..Publio--Wox.ks for the government of Plumbers. , j
It I. futher agreed by the undersigned that no other use. will be made of the above connection, ~c.pt a hereinafter listed.
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Phunblng In......~; -0-----
STATE OF WISCONSIN)
) 5S
I~NEBAGO COUNTY) . I ' '~o
\ ~JÙ~ f,__~ilitr::J&b~k ¿j /1 ~ ~
~ã~e) \Address}
being first duly sworn on o~ deposes and says th~t he is not
~ licensed plumb'c-r. and th¿¡t he h~s ~pplied for a plumbing
permit to the Plumbing Inspector of the City of Oshkosh, to do
plumbing wc.rk in i) home owned and occupied by him, or a home
that is being constructed that is owned by him, and which will
bE! occupieÔby him ó,s his home when completed. That he is not
building said home for the purpose of sale.
This affidavit is made for the purpose of complying with
the provisions of the plumbing code of the City of Oshkosh and
the State of Wisconsin, which provides that all plumbing work
must be done by i) licensed plumber except that the plumbing work
may be done b9 one ~ho owns and occupies his own home providing
the installation complies with the plumbing code of the City of
Oshkosh and the State of Wisconsin.
..
This affiant understands that the Plumbing work authorized
by the permit applied for, must be done only by this affiant and
that he canno':; pmplov others who ,are not licensed plumbers to
""':,:~:ht::: 1~ ~' ~~ ~
oSLI,bs"c,r,;b,.ed an,' ,"or" þ,J~, ~~.
thiSh day of , , 19 7t. ~
Nota~-WI ne 0 c:unty, ~onsI~
My Commission,Expires:--_~02-~~_~_--