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PLUMBING PERMIT - Os~kosh, Wisconsin Permit N? 8122
fu.JJ f> }.. -- . Hame æ /1-+_:".' ;"" ...+-- +. Street
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LLo1 No. I Block I Ward /Addifu,n or ReplEd
OUTSIDE WORK
Dale
NEW SEWER WATER STORMS 'EES 'EES RE'AY S. SEW" WATE. STORMS 'EES
From Mala to Curb . Septic Tanks From Main to> Curb
Fzom Curb So BuIldlnø 9-/;{1£ l/t~ ~ " "* 06 Electric Pumps From Curb to Building
7/ Repair
INSIDE WORK
NO. NEW "P. USED FRES NO. NEW I RIP. USEO 'EES NO. NEW REP. us,. m.
Bath Tub Garbage Dbpoea1a -- CEdch Basins
I--
Wub Basin Dishwashers - Couduclors
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Wilier CIooet LaundramEdR Gre..... Catch Basins
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SIAk Water Softeners Sump Pump 8< Ejectors
Wilier Heate.. Sanitary Bubble.. Bar and Soda Wastes
Sho"".. BatIus UriDaJs
FIocw »raIDs Dental Cuspidors
Laundry TuIn Service Sinks
IDlpsctioDi :l~~2~ :~~~-- =:~:_::~~:_~:::: Fee Verified. Receipted and Recorded R~:q:,~~~:":e:r;::lon Fe..
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--------------- -----------InSiCIe _-LQ_9__----PIbs, Fees
$---------------------------------------------------- ------!f-dJ{)--___Total
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Date VIr, ') ~
In the performance of, this work tho undarsigned owner (or hi. authorized agent) of .aid premi... and hi. authorlz.d Plumber hereby agree to be bounden by end
submit to all statutes, city ordinances, and rul.. end regulation. proscribed by the Board of Public Work. for the goyernment of Plumber..
It I. futher agreed by the undersigned that no other uses will be mode of the above connection. except a. hereinafter listed.
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