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OUTSIDE WORK
I Addition or Replat
Date
-.
NEW SEwn WATn STORMS 'EES 'EES RElAY S. SEWER WATER STORMS FEES
From MaIn 10 Curb Septic Tanks From Main 10 Curb
FJom Curb 10 Building Electric Pumps From Curb 10 Building
Repair
INSIDE WORK
110.
NEW
....
NEW
REP. I USE.
FEES
FEES
NO.
NEW
REP.
USE.
USED
FlES
NO.
B8Ib Tub
Garbage DiIpoAIs
Catch BulDs
Wash Buin
Dlsh.uhen
Conduclon
Water CI_I
Laundramau
Gre... Catch BuiDR
+--
SIJIk
Water Softenen
Sump Pump III: Ejeclon
J-I
(/'
Sanitary Bubblen
UriDale
Bar and Soda Wasles
Wúer Heate..
~
Show.. Baths
noør Dr8Ù18
Denial Cuspldo..
Laundry Tubs
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Service Sinks
Fee Verified. Receipled and Recorded
Valuation of Ihe Work Herein Described
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Received Permit and Inspeclion Fees
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City T,..."..
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In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumb.r hereby agrae to be bounden by and
submit to all statutes, city ordinances, and rules and regulations prescribed by the Board of Public Works for t~e gove!:JUMIÚ of Plumbers.
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