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Name
of
Plumber
-4JL~-- p z B;~~kO:~~:o.'i /£.27;:~ZŠ
I Lot No. I Block I Ward I Addilion or Replat
OUTSIDE WORK
17
Date
..
NEW SEWEI WAT" STORMS fEES fEES RELAY S. SEWER WATER STORMS fEES
From MaIn 10 ClI1'b Septic Tanks From Main 10 Curb
From ClI1'b to DuDding V ~ -:l(jCJ Electric Pumps From ClI1'b 10 Building
Repair
INSIDE WORK
NO. NEW RIP. USED flES NO. NEW REP. USED FEES NO. NEW REP. USED FEES
- - - -
Bath Tub Garbage DispDoaIs Cateb Basins
- -
Wuh Basin Dishwashers Conduelors
- - - - -
Weier CI_t Laundrilm&lo Gr- Celeh Basins
-
Sink Weier Softeners Sump Pump" Ejeclors
Weier Heelers Sanitary Bubblers Bar and Soda Wasles
Shower Batba Urinals
noor Dr8Ül8 Denial Cuspidors
Laundry Tube Service Sinks
IDlJ)8Cllons Valuation of Ihe Work Herein Described Fee Verified, Receipled and Recorded Received Permit and Inspecllon Fear
.-...-......---..-............-m...........OuWde $..él.;;z¿.~................_.._................... 4^""'"/- .- ¡
..............-.........-...-..-..........._........Inslde ...../~.......PIbg. Fees
~=-~~~:(¡¡;~~~~;. $ m.............. .......................... -.....- ..... ................... ......... .....~....Tolal
....... """"ëí.ïT;~.~;ë;"""""'.""".'."'" Dale If) -jj. 7
$......................................... .......-..............-..-.
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submit to ell statutes, city ordinances, and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
that no other uses will be mode of the ebove connections except as hereineftor
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