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L~~lfO'~m_~ --. . . I Block I Ward. I Addilion or Replat ~
OUTSIDE WORK
Dale
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NIW SEW" WAtER STORMS fEEs 'EES RELAY S. sEW'R WATER STORMS fEES
F- Main to Curb Septic Tanks From Main 10 Curb
I'Iom Curb 10 Building Electric Pumps From Curb to Building
Repm
INSIDE WORK
MO. NIW RIP. USEO NES NO. NOW R'P. USED 'EES NO. N'W REP. USED 'EES
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BaIb - '1'Ub -( .., ¡ - -, Garbaga Dis~ Celeb Basins
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WulrBalD-- ~ .<L ¡ Disbw...hen Conductors
)1 Y] ",:t>~ -- - - - - -
W_CloMt '.'. ' I Laundram&ts Gre",", Celeb BalDs
81z11c ./ Weier Softeners Sump Pump 8< Ejectors
WaIe~ Hoolen SaniI¡uy Bubblers Bar and Soda Wastes
8M"". .Baths UrinaJa 1ß1/N r-í- l/dW
"I... "y<:,p
Floor Dr" Dental Cuspidors
Launcky Tuho Senico Sinks
Inapoctions Valuelion of the Work Herein Descrihod Fee Verified. Receipted and Recorded Received Permil and Inspection Fees
---------...----------Oubide ~d '!;!i --"'-i7Fil-"'.sewo~ Fees
$---------->.2----------------------------------
-----------.-----------Inaide ---- . U1;¡-.PIbg. Fees
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-------_..----F1DaI OK $--------------------------.......----------- Dele /v- /C/-- ?,;:;
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 and
submit to all statutes, city ordinances, and rul.. and regulations prescribed by the Board of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no olher uses will be made of the above connections except as h~reinaft.r lisled.
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Coo- -- ..-- - Plumbing 1.0_;:7-
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