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PLUMBING PERMIT - Oshkosh,
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I L<>I No. I Block I Ward
OUTSIDE WORK
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I Addilion or Replat
Dale
NEW SEWn WATER STORMS fEES fEES RElAY S- SEWER WATER STORMS fEES
From Main to Curb Septic Tanks From Main to Curb
~m Curb to BuDdlng Electric Pumps From Curb to Buildlng
Repair
INSIDE WORK
NO. NEW "P. USED RES NO. NEW REP, USED fEES NO. NEW REP. USED fEES
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Bath Tub / /.H) Garbage DIIposaIs Catch Basins
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Wash BaslD I ¡J-() Dishwashers Conductors
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Wal.. CIONt I tJV LaundramaIJ I rO Grease Calch BaslDl
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SbIk I Waler Softeners Sump Pump" Ejeclors I I'
Waler Healers I j. ð-(j Sanilary Bubblers Bar and Soda Wastes
Show.. Balbs Urløala
Floor Draløa I J,t7V Dental Cuspidors
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Laundry Tube Service SlDb
IDlpect!ons Valuation of the ~ HerelD Described Fee Verü¡ed. Receipted and Recorded Received Permit and Inspection Fees
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$--------------------------------------- ______n__--________n__n--------- Date / /-- f?> 7(0
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In the performance of this work the undersigned owner (or his authorized agent) of said premise. and his authorized Plumber hereby agr.. to b. bound.n 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 futh.r agreed by the undersigned that no other uses will b. made of the above connections e-"cept a. hereinaf!Ø'r listed.
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