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PLUMBING PERMIT - Oshkosh, Wisconsin
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I Block I Ward
Permit Nr: 8677
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I Lot Ho.
J Addition or Replat
Dafe
OUTSIDE WORK
NIW SOWEI WAnR srORMs FEES FEES RE'AY S. SEWER WAfER srORMS FEES
holD MaIn to Curb Seplic Tanks From Main 10 Curb
Flow Curb tn BuDding Electric Pumps From Curb 10 Building
Repair
NO.
INSIDE WORK
/NEW ~IUS'DI~I~' INEWIREP'I~I~
Garbage DizpoIaJa I C- Bow
NEW
Bath Tub
Wash Buin
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Dishwashers
Couduciors
Wat. Closet
-1-
Launclramais
Grease Catch Basins
81D11:
Water Sofleners
Sump Pump 11< Ejeclors
Wafer Heaters
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Bar and SocIa Wasles
jDO
8""..... Batha
Sanitary Bubblers
Urinals
Floor Drelna
Denial Cuspidors
Laundzy TuboI
Service Sinks
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¡nspeclions Valu~n of Ihe Work Herein Described Fee Verified, Receipled and Recorded Received Permit ancllnspeclion Fees
-------------..----Outsicle $ '::.Lj!:. Ó â'ò -----:¡;.¡--------------Sewer Fees
------------------Insic1e ----... --- ...._-..L_..___..------------.......-- .._'"PI--k..Ç[Q_..:Plbg. Fees
"--"':J-tT::-I 1~--- $....--....---..----..---...------..--...---..------. ----""----"-----"'c¡jÿ-ÿ;...~;;;""""--"-""""--- ------/.-,,--I2..O:-~TOial
..-:;'?.(-l.-ì.JI)Y."...------FiDal OX $------..-----..------------..-------------------- Date" I ~ I A ~
In the perlormance of this work the undersigned owner (or his authorized agent) of seid preml..s and his autherized Plumber hereby agree to be bounden by and
submit to all statutes, city ordinances, and rules and regula' Ions prescribed by 'he B~ard of Public Works for the government of Plumbers.
It is futh"r agreed by the undersigned that no other uses will be made of the aboye connections except as herelnaftar Ii.ted.
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PlumbIng Ins_,
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