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OUTSIDE WORK
Date
NOW SEWEI WATER STORMS FEES FEES RElAY S. SEWER WATER STORMS feES
From MaIn 10 Curb Septic Tanks From Main to Curb
Foam Curb 10 BuDding Electric Pumpe From Curb to Building
Repair
INSIDE WORK
NO.
RIP.
feES
NEW
USED
FlES
NO.
NEW
REP. I USED
FEES
1<0.
NEW
REP.
USED
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:/-
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,/
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Sump Pump 8< Ejectors
/,tW
Beth Tub
Garbage DiaposaJa
Catch BaslDs
Wuh BasIø
Diahwashers
Conductors
Will.. Cloeel
LaundrlUl18Ù
Grease Catch Basins
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SIDk
Water Softeners
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L
Wale. Hellien
Sanitary Bubblers
Bar and Soda Wastes
Show.. Batba
Urinals
FlOO2 DoÜDI
Dental Cuspidon
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Laundry Tube
Service Sinks
InspedloD8
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Valualion of the Work Herein Deacribed
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$
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Fee Verified. Receipted and Recorded
Received Permit and Inspecllon Fe..
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Date 3-(p -?f
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In the performance 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 atatutes. city ordinances. and rules and rogulations proscribed by the Board of Public Works for t e government of Plumbers.
nderslgned that no other uses will be mede of the above connections except as
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