HomeMy WebLinkAbout0000789 P
~~
"
I
/
z. ~~~¿g-,~PŽ:HT_-~;:nåJdf~#~.
Dù.1 Lot No. ~ I Ward ~ l Addition or Replat
OUTSIDE WORK
NEW SEWEI WATER STORMS FEES fEES RElAY S. SEWER WATER STORMS fEES
From MaID 10 Cub Seplic Tank. From Main 10 Curb
From Cub 10 BuDding Electric Pumps From Cub 10 Building
Repair
INSIDE WORK
NO.
NEW
u,.
USID
NO.
NEW
."'1 USE. I fEES
NEW
USE.
fEES
1<0.
REP.
"ES
Bùb Tub
Garbage Dilpooak
Cùeb BulDs
1-
Wuh Buin
Dilhwuhen
Conduclors
I~-'-
WÙH Clooal
LaundrlUDlWl
Gre... Cùch BulDs
SIDk
Wùar Softaners
Sump Pump II< Ejeclors
Wmr H.ù...
/
;.0(.)
Sanilary Bubblers
Bar and Soda Wule.
ShOWH BaIhs
Urinals
noor DraIDI
Denial Cuspidors
Laundry Tubs
~:=---::_.._--------_.----_._.._.___Oulside
Serrice Sinks
Fee Verified, Receipted and Recorded
Received Permi! and Inspeclion Fe..
-_:::..3:..:~:_~~~r F:7
/¿J-//.77
.------.....----------....--..----...-.-----__....--Inside
Valualion of Ihe Work Herein Described
c:J~ HJ
$ m--- -- --- - - - - -.. ----------- - ----- ....--.------ -.-----..
$-
.
Dùe
-------.....-.-.---..--.------.---.--------
C;ty T....u,.,
-
----.---.-------...------F1na1 OK
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 ond
submit to all statutes, city ordinance., and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
It is futher agreed by the undersigned that no other uses will ba mede of the above connections except as hereinalter listed.
=~~=:~::~::~~;i~¡::~:_:_---::__::_.:.._-----_:_-_....:~----::_:
f~-~.-