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PLUMBING PERMIT - Osh~, ~ Permll NI?
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I Lol No. I Block I Ward I Addilion or Replal
OUTSIDE WORK
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755
Date
Naw SEWn WAn. STORMS FEES FEES .ElAY S- SEWE. WATER STORMS FEES
From MaIn 10 Curb Seplic Tanks From Main 10 Curb
From Curb 10 BuJldlnll Eleclrlc Pumps From Curb 10 Building
Repair V' /I'&ð
INSIDE WORK
NO.
NEW
UP-
NEW
FEES
FEES
NO.
NEW
.EP.
USE.
.EP. I USE.
USED
FlES
NO.
Beth Tub
Garbage DiI~
Caleb Basins
Wuh Buln
Dilbwuben
Conducl.rs
Water CI_I
Laundrama.ll
Grease Catcb Bulns
f-
SIJl1o:
Water Softeners
Sump Pump Be Ejeclors
WlÙ8r Heaters
Sanllary Bubblers
Bar and Soda Walles
Shower BaIhI
UrIna1a
noor Drlliu
Denial Cuspidors
Laundry Tube
lasped!ons
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Service Sinks
Fee Verified. Recelpled and Recorded
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Received Permit and Inspection Fees
----_/Lt':J2m--mSewer Fees
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Inl the' perl;;rmance 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 statutes, city ordinances, and rules and regulations prescribed by the Board of Public Works for the goJt(>rnment of Plumbers.
he undersigned that no other uses will be made of the above connections except as herei
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