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Dale I Lo.t No. I~ I Ward I Addilion or Replal
OUTSIDE WORK
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NEW SEWEI WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS lEES
From MaIn 10 Curb Seplic Tanks From Main 10 Curb
.....,.. Curb 10 Building / ¡..../ 4,cò Eleclric Pumps From Curb 10 Building
Repair
INSIDE WORK
110. NEW UP. USEII FlES NO. NEW REP. USED FEES NO. NEW REP. USED FEES
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B&Ib Tub Gubage Dispooab C&Ich BaslDs
Wub Basin Dishwashen Conducloro
- - - - - -
WaiN CI_I Laundramals Greue Caleh BaslDs
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Sink Waler Softene.. Sump Pump &: Ejeclo..
Waler Heale.. Sanitary Bubble.. Bu and Soda Wasleo
Shower Ba1h8 Urinals
noor DraIDs Denial Cuopidon
- - -
Laundry Tubs Serrice Sinks
IDipecliODS :a;~~r.:..:::::.::::.:: Fee Verified. Receipled and Recorded Received PermU and Inopection Fees
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premises and his authorized Plumber hereby agre
oubmlt to all statutes. city ordinances, and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
the undersigned that no other uses will be made of the above connections except as hereinafter listed.
0 bo bounden by ond
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