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Dale I LoJ No. I Block I Ward I Addüion or Replal
OUTSIDE WORK
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1672
00'00_'00_"""--
NEW SEW" WATER STORMS FEES FEES RE'AY S. SEWER WATER STORMS FEE'
From M81D to ClUb Septic Tanks From Main to Curb '/ 3,ùÒ
From ClUb to BuDding Electric Pumps From ClUb to Building
Repair
INSIDE WORK
NO.
NEW
RE'.
FEES
USID
NO.
NEW
RE,. I USED
FEES
NO.
"ES
NEW
RE,.
USED
Beth Tub
Garbage DiIpo8a1s
Dishwashers
Conductors
Caich BasIDs
Wuh Bum
Weter Cl_t
Laundramall
Grease Calch BaslDll
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SIDk
Waler Softeners
Sump Pump 8< Ejectors
Waler Healers
Sanitary Bubblers
Bar and Soda Wastes
Shower Beths
Urinals
F1oor DraIDa
Dental Cuspidors
Leundry Tube
Service Sinks
~:~::_...mm._--...._...mn....Ou~ide ~ :5~å:~.~n=:~::.:::=.:: Fee Verified. Receipted and Recorded R~e~~.~:~.s:n;e:ns:,:lion Feel
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In the performance of this work the undersigned OWner (or his euthorized agent) of said premises and his authorized Plumber hereby egree to be bounden by end
submit to all statutes. city ordinances. and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
It Is futher agreed bY~ undersigned th.t no other uses will be made of the above connections except as hereinaftar listed.
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