HomeMy WebLinkAbout0001069 P
.......,
)
,)
~~~;;::::å~~~~~:¿
-. r:z~
I Lo.I No. I Block t7 I Ward I Addilion or Replat '
OUTSIDE WORK
Date
NEW SEW" WAlE. STORMS FEOS FEES .ELAY S. SEWE. WATE. STORMS FEES
From MaIn to Curb Septic Tanks From Main to Curb
From Curb to Building Eleclric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
'EES
..,.
USEO
FlOS
NO.
NEW
.E'. I USE.
'EES
"O.
NEW
.E'.
USE.
Batb Tub
Garbage Dispooa1s
Catch Basins
f---
Wub Basin
Dishwashers
Conductors
Watu Cl_t
Laundr-
Gre... Catch Basins
I--
Sink
Water Softeners
Sump Pump 8< Ejectors
Water Heate..
I
II~
Bar and Soda Wast..
Sanilary Bubblers
Shower Batbs
UriDala
Floor Dr8lu
Dental Cuspidors
Laundry Tubs
Service Sinks
Inspecttons --.-......-Outside
~=:~:~:::::::=::=::==:~-~=:::....m._.m....Ins¡de
Valuation of the Work Herein Described
6l..00,t>--()
$ - 000 000 000 000 m. 000 00000000.. 000 00000000 000 ..000.000_.000000000 mmm.
$"""'_"""""'-"""00000000'000000__000_000""'00000000000000"
$_000 000 000000 _000'__000" 000 '__'00 ... ----- --__000'000000"00__'-
Date
Fee Verified. Receipted and Recorded
Recaived Permil and Inspection F-
-_mn_-Se...er F-
.000_::::7.:~::; Fees
..3 .n';¿ . 7 J'"
'-"""-ë',¡ÿ'ÿ;;;,,;;;;;---..--__....n_.m
___nm.______.mnm_--FiDal OK
In the performance of thi. work the under.igned owner (or hi. authorired agent) of said premise. and hi. authorired Plumber hereby agree to be bounden by and
submit to all .tatute.. city ordinances. and rule. and regulation. pre.cribed by the Board of Public Work> for the government of Plumbe".
It I. futher agreed by the undersigned that no other u... will be made of the above connection. except a. hereinafter Ii.ted.
=~=~::~~~¡~:~:.:~:::...__:...::....::..:_:-_:::.:::_-
n_m_~~m