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I Lot No. b I Ward I Addition or Replot
OUTSIDE WORK
Dale
NEW SEWD WATE. STORMS FEES FEES 'ELAY S. SEWE' WATE. STORMS "ES
From Main to Curb Septic Tanks From Main to Curb
~m Curb to BuDding ./' ¡../' ¿J.cV Eleotrlo Pumps From Curb to Building
Repair
INSIDE WORK
110.
NEW
USED
"~H..
Conductors
NEW
'EP.
USE.
FEES
NO.
"ES
"ES
NO.
UP.
BaIh Tub
Garbage DilpoAIs
Catch Basins
Wuh Basin
Dilbwasbers
Waler Cl_t
Laundramals
Grease Caloh Basins
SIDk
Waler Softeners
Sump Pump" Ejectors
Waler Healers
Sanitary Bubblers
Bar and Soda Wastes
Shower Baths
Urinals
Floor DraIDa
Dental Cuspidors
Laundry Tube
Senioe Sinks
Insped1o11S Valuation of , the Work Herein Desc:ribed Fee Verified. Receipted and Recorded Received Permit and Inspection Fe..
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In the performance of this work tha undersigned owner (or his authorlred agent) of said premises and his authorized Plumber hereby ag;aa to be boundan by and
submit to all statutes. city ordinances. and rules and regulations prescribed by the Soard of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other usas will be made of the above connections except as herelnaltor