HomeMy WebLinkAbout0001015-Plumbing (lateral)
",)
~
)
Name
of
PIWllber
~ - - - p zz:; ~ ~::z.:it Æ 62-; :¿:I ~ 0 ~ ~-
I Lot No. 1- .Block I Ward I Addilion or Replal
Dale
OUTSIDE WORK
NEW SIWEI WATER STORMS FEIS FE IS RELAY S. SEWIR WATER STORMS FEES
From MaIn 10 Curb Seplic Tanks From Main 10 Curb
~m Curb 10 Bulld1ng Eleclric Pumps From Curb 10 Bunding
Repair /' /,.mJ
INSIDE WORK
NO.
UP. I USED I FlES I NO.
FEU
NEW
NEW
REP. I USED
FEES
NO.
NIW
REP.
USED
Bath Tub
Garbage Dlapon1o
Caich Basins
Wash Basin
Dishwashers
Conduclors
Water Cl_t
Leundramats
Grease Caleh Basins
SID1o:
I---
Waler Softeners
Sump Pump" Ejeclors
Waler Heaters
Shower Balha
Sanitary Bubblers
UriDela
Bar and Soda Waste.
Floor Dr8IDs
Denial Cuspidors
Laundry Tubo
SerYice Sinks
~:~.::_.._-_.---------__---___n_Ou~ide :/;~n~:~:_::~::_::~:=: Fee Verified. Receipled and Recorded R~eï.;_~~:~_S:'::e:n=lion F-
----------------------..--------------.-----------Inø,de --------------..._---------.Plbg. Fee.
==~~I4-'il--:??~;';'¡-~; :_:n::::-~_:::::::::::::::::::-:::-::::~:::::~:-~:::::::::::::-~::~-------_.--------ëííÿ-ÿ;~;;~;~;-----------------'------ D~~:¿;av;-_._- Tolel
In the pe ormlnce 01 this work the undersigned owner (or his luthorired agent) of slid premises and his authorized Plumber hereby Igree
submit to all statutes. city ordinlnc... and rulos and regulations prescribed by the Board of Public Works lor the government 01 Plumbers.
It Is luther agreed by the undersigned thlt no other uses will be made 01 the Ibove connections except as hereinlltor listed.
f~n~----
___---n'--n_n-