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Name
of
Plumber
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Dale
I Addition or Replat
OUTSIDE WORK
NIW SlW.. WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn to Curb Septic Tanks From Main to Curb
him Curb to BuUcIlnll Electric Pumps From Curb to BuUcIlng
Repair ~ 1,Dl:)
INSIDE WORK
110. NEW UP. USED FRES NO. NEW REP. USE. FEES NO. NEW REP. USED FEES
- - -
B&Ib Tub Garbage DÙlponJo C&Ich Basins
Wub Basin DÙlhwashers Conductors
- - -
Waler ClOlOt LaundrlUl1&la Gre... Calch Basins
-
Sink Waler Softeners Sump Pump" Ejectors
W&Ier Healers Sanitary Bubblers Bar and Soda Wastes
Shower Balba Urinals
Floor DraIDa Dental Cuspidors 1.-
Leundry Tubs Service Sinks
IDllpections ValuatIon of the Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Inspection Feee
--............-................................Outside $$SY-...........................................- ................. ........Sewer Feoa
...................................m....................IDllide -Lu~2þ...........plbg. Fees
""'-'~l~~~m~; . $............................................................................ ...(L~.............Total
$..........................................................................- .......................... c',., T;ëä.~;.;"""'" ................. Date /J44?,.. L
.. .. .. ,. ... .... ... .. . -. ..0
submit to all statutes, city ordinances, and rules and regulations prescribed by the Boud of Public Works for the government of Plumbers.
It Is futher agreed.JIy the undersigned thst no other uses will be mode of the above connections except as hereinalter listed.
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