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PLUMBING PERMIT ~ O$hko$h, Wi$con$in PermitN? 82'08
'"' " Sueet
_._._._----_..~----_...~~--.-'::!r _n_n__~_---~------ N::'ber ------/~_~__n--¥~-
-I~~_J Ward
D-
¡ Lot Ro.
In""ddiH_on_or Replat
OUTSIDE WORK
NEW SEWE8 WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
F- MaIn 10 C\U'b Septic Tanks From Main 10 Curb
From C\U'b 10 BuilcIID Elecuic Pumps From Curb 10 Building
Repair
INSIDE WORK
MD. NEW UP. OSID FlES NO. NEW REP. "SE' FEES NO. NEW REP. USE' FEES
1- - - - - -
Bath Tub Garbage DÏ8pon]Jo Cdcb Basins
WuIa BuiD Diabwasben Conductors
I---------- - -
Wet"" Clolat Lawulramats Grease Catcb Basm.
SIDk Weter Softeners Sump Pump it Ejectors
WatH Heaten Sanitary Bubblers Bar and Soda Wastes
811.0- .Baths UriDaIa j J I, Va
Floor Dralu Denial Cuspidors
Laundry Tubs Service SiDks
JupodlOJ18 Valuation of tbe Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Inspection Fees
--------------_..----OuÞide $ -_!:.~Q-... -«--()..ð.._--..-..-----...---.....- ---Jt------_n--------Sower Foes
-...---..----.__--_.Insldo .._--~~..~...-Plbg. Fee.
-------------- $------..-....------....------------------------------ --___-.Lu2_?L..Total
-------FiDal OX $- "--"------------------CI¡Y-T;;;;';~;;;-------"------------- Date .J.. to, 7:S -
- -- -- n_- -- --- - . .3
In the performance of this work the undersigned owner (or his authorized agent) 01 said premises and his aulhorizoo Plumber hereby agree to b.e bounden by and
submit to all statutes, city ordinances, and rules and regulations prescribed by the Board 01 Public Works lor the government 01 Plumbers.
It Is luther agreed by the undersigned that no other usos will be made 01 the above <onne.tions ex.ept as hereinaller listed.
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