HomeMy WebLinkAbout0001775 P
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I Lot No. I Block I Ward I Addilion or Replal
OUTSIDE WORK
Dale
NIW SEwn WAIER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaiD to Curb Seplic Tanks From Main 10 Curb
From Curb 10 Building Eleclric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO.
NIW
UP.
NEW
REP. I USED
FEES
FEES
NO.
NEW
REP.
USED
USID
FlES
NO.
/
./
Garbage DiIposaIo
Calch BaslDs
1(""""'-
BaIh Tub
Wasb Basin
Dishwashers
Conduciotl
-,-
Water CIONI
Laundramaù
Grease Catch BasIDR
I--
SiDk
Water Soflenetl
Sump Pump" Ejeclotl
Waler Heaten
Sanituy Bubblers
UriDale
Bar and Soda Wasles
Shower Balba
F1oor Dra1Ds
Dental Cuspidon
Laundry Tube
Inspections
M=~~~ j
------.---.---______n_--FiDaI OK
SerYlce Sinks
Fee Verified. Receipled and Recorded
Valualion 01 Ihe Work Herein Described
$~7q_:X-n_____-------------------m_--
$.
e
Received Per mil and Inspeclion F-
----..-._---____nn_nm_-SeW8r Fees
/, 00
L~?;;~;;V.
00---0000------------_-------------------_----------0000
City T"...",
In th& performance of thi, work the undersigned owner (or hi, authorired agent) of ,aid premise, and hi, authorized Plumber hereby agree to be bounden by and
submit to all ,tatutes, city ordinances, and rul.. and regulations prescribed by Ihe Board of Public Works for the governmenl of Plumbers.
II Is futher agreed by the unjl9rslgned Ihal no other uses will be made of the above connections excepl a, hereinafter 1i,led.
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