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PLUMBING PERMIT - Oshkosh, Wisconsin. Permit N? 9163 4.
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I Lot No. I Block I Ward I Jl.ddilion or Replal
Dale
OUTSIDE WORK
NEW SEW" WA"R STORMS FEES FEES RELAY S. SEWER WA"R STORMS fEES
From MaIn 10 Curb Seplic Tanks From Main 10 Curb
~1D Curb 10 BuDding Elecldc Pumps From Curb 10 Building
Repair
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INSIDE WORK
NO.
NEW
NO.
NO.
fEES
NEW
REP. I USED
FEES
NEW
REP.
USED
RE'.
USED
fEES
BaIb Tub
Garbaga Diopooals
Calch Basins
I------
Wash Basin
Dishwashers
Conduclors
Waler Clolel
Laundramals
Gre... Calch Basins
-
SIDk
Waler Sofleners
Sump Pump" Ejeclors
Waier Healers
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Bar and Soda Wasles
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Sanilary Bubblers
Shower Balha
Urinals
noor Ðralu
Denial Cuspidors
Laundry Tubs
~~:.:..--_..._---------._--..--.Oulside
Servlc:e Sinks
Fee Verified. Receipled and Recorded
Valualion of Ihe Work Herein Described
$.../.2.5....'?:...--...-..---------.....--....--..
$.........--.--... .....--...------.-----.--------.---..----.----....
$----....--......--.------.........---..--....--------.........--...-...
Received Permit and Inspecllon Fees
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Dale ~/~~ 7&'
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In the performance of thi. work the undersigned owner (or his authorized agent) of .aid premise. and his authorized Plumber hereby agree to be bounden by and
submit to all 5Iatutes, city ordinances, and rules and regulations pre.cribed by the Board of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other U5O. will be made of the above connections except a. hereinalter Ii.ted.
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