HomeMy WebLinkAbout0001247-Plumbing (fixtures)
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I Lot No. I Block I Ward I Addition or Replat
OUTSIDE WORK
Dille
NEW SEWEa WATER STORMs FEES FEES RELAY S. sEWER WATER STORMs FEEs
From MaIn to Curb Seplic Tanks From Main to Curb
From Curb to BuUdtog Eleclric Pumpo From Curb to Building
Repair
INSIDE WORK
NO.
"',.
fEES
NEW
UsED
HES
NO.
NEW
REP. I UsED
FEES
NO.
NEW
REP.
UsED
1
1-
$J
.L
I
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Bath Tub
(,00
(,"0
Garbage Dispooals
Catch Bastos
,/
Wuh Basin
Dishwashers
Conducto..
(.00
Water CI_t
Laundumats
/
Grease Catch Basw
.~,
J
Sink
Water Softene..
Sump Pump II: Ejeclo..
/
Wate. Heaten
Shower Bathe
Sanitary Bubble..
Urtools
Bar and Soda Wasles
Floor Dralu
Dental Cuspidon
Laundry Tubo
IlISpocIions
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--...-- .- -Ftoal OK I $.
Service Stoles
Valuallon of Ihe Work Hereto Described
$.2l,.O~....................._.._..............-
.
Fee Verified. Receipled and Recorded
Received Permil and Inspecllon Feet
............................Sewe. Fees
....j/~.Qg....Plbg. Fees
........!f....<:>.<:J....Total
Dale .$/I/;;/
owner (or his authorized agent) of said premises and his authorized Plumbar hareby agree to be bounden by ...d
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submit to all statutes. city ordinances, and rules and regulations prescribed by the Boord of Public Works for the government of Plumbers.
'e undersigned that no other use. will be made of the above connections except as hereinafter listed.
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