HomeMy WebLinkAbout0000805-Plumbing (laterals)
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Due I Lot No. I Block I Ward I Addition or Replat
OUTSIDE WORK
Naw SEW" WATE. STORMS fEES 'EES .ELAY S. SEWE. WATE. STORMS fEES
From MaiD 10 Curb Septic Tanks From Main 10 Curb
~ Curb 10 BuDding V ~ iob Electric Pumps From Curb 10 BuUdhtg
Repair
Received Permit and Inspecllon Fees
---~~_G1:O.----__--Sewer F...
_--I_'_~_.--.._.._Plbg. F..s
------_.t:/.._~_.-----Tolal
Date /ó .4/h'7
INSIDE WORK
NO.
NEW
u,.
NO.
NEW
.E,. I USE.
NO.
FEES
USED
FlES
BaIb Tub
Garbage DIs~
Catch Basins
f------
Wub Basin
Dishwashen
Conductors
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Wu.. CI_I
Laundrarna1s
Gre... Cuch Basins
Sink
Wuer Soften...
Sump Pump II< Ejeclors
Waler Beuers
Sanitary Bubblers
Bar and Soda Wasles
Show.. BUbs
Urinals
noor Dralno
Denial Cuspidors
-I----
Laundry Tube
~:~:_._-----______m__--.._--_____Oullide
Sernce Sinks
--------------------....------------...--.-------.--..Inside
Valuation of the Work Herein Described
$----;¿-~(2.,-~-------------------------.--..-----------_._--
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Fee Verified, Receipled and Recorded
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-----------..----------------._------....----..--._..
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, In ¡he porformence of thi. work the undenigned owner (or hi. authorized agent) of .aid prem!s.. and hi. authorired Plumber hereby agree to be bounden
submit to ell .tatute., city ordinances, and rules and regulation. prescribed by the Board of Public Work> for the government of Plumbe".
It is futher egreed .\>y the undersigned that no other u5O' will be made of the above connections except a. hereinafter listed.
City T....u",
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NEW
.E,.
USE.
flES
I--
by and
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