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I Lot No. I B!~k I Ward I Addition or Replat i
Data
OUTSIDE WORK
NEW SEwn WATER STORMS 'EES 'EES .ELAY S. SEWER WATER STORMS FEES
From MaIn 10 Curb Septic TankE From Main 10 Curb
From Curb 10 BuDding Eleclrlc Pumpa From Curb 10 Building
Repair
INSIDE WORK
NO. NEW RE'. USIC FlES NO. NEW .EP. USED FEES rlO. NEW .EP. USED FEES
- - ~ - - ~
BaIb Tub Garbaga D~ Catch Buins
~
Wub Bulu Dishwuben Conduclon
1- - ~ - ~
WatN CI_1 LaundrematR Gr- Catch Buins
f--
SiDk Water Softenan Sump Pump" Ejecton
W8I8r Haatan J rl! Sanil81'T Bubblen Bar and Soda Wules
ShowN Bathe UrlnaJa
Floor Drains Denial Cuspidon
Laundry Tuba Sernce Sluka
Iupactiou Valuallon of tbe Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Inspection F-
--....-.-....---..-....-......................Oulside $....~.qi..~~..............._................_.. ::.::..1:~£~~r F:7
..........................-....................-........lnRlde
...........-.............--.-............-......-......- $... ......................................-............_.................
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--..-.-.-.-.......--EiDal OK $......................-..............................................- Date J./~.'77
In the performance of this work the undersigned owner (or his authorired agent) of said premises and his authorized Plumber hereby agree to be boundon by and
submit to all statutes, city ordinances, and rulos and regulations prescribod by the Board of Public Works for the governmont of Plumbers.
It I. futher agreed by the undersigned that no other u... will bo made of the above connection. except as hereinafter listed.
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