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I Lot Ho. I Block I Ward I Addilion or Raplat
OUTSIDE WORK
Data
NEW SEWD WAlE. STORMS FEES fEES .ELAY S. SEWER WAlE. STORMS FE"
From MaID 10 C\I1'b Seplic Tank. From Main 10 Curb ;/ ./ ~
Fzom C\I1'b 10 BuDding Electric Pumps From C\I1'b 10 Building / /
Repair
INSIDE WORK
NO.
NEW
fEES
RE'.
U!EO
fI..
NO.
NEW
.EP. I USEO
"O.
FEES
NEW
.EP.
USI.
Bath Tub
Garbaga DloponJo
Caich Bulns
Wub Buin
Dlohwuhan
Conductors
Water CI_I
Laundramlllo
Gra... Catch Bulns
I--
Sink:
Watar Softanerl
Sump Pump Ik Ejectors
Watar Haatars
Sanitary Bubblers
Bar and Soda Wules
Shower Baths
Urinals
F1oor Dralu
Denial Cuspidors
Laundry Tuba
Service Sinks
~:~::_-------------........_....---Oullide :~;L;;;--~:..:::::_:::==: Fee Verified. Receipled and Recorded R~eS~~=~_S:~e:n;:lIon Fees
=~~iil;j~~~~ . ::::__:::::::~::::::::::::::::::::::::::::~:::::~:::::::~:::::::::~::~ -.._- '------Clïý-T~;;~;~;-'----------'------------- D~~:~~:=~;;;""
In the perlormance of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by and
submit to all statutes, city ordinance., and rules and regulations prescribed by the Board of Public Works for the gove~Pment of Plumbers.
It Is futher agreed by !~e undersigned that no other uses will be made of the above connections except as