HomeMy WebLinkAbout0000126-Plumbing (sewer & water)
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Dllie I Lot No. I Block I Ward .....m I Addition or Replat
OUTSIDE WORK
NIW SIWEI WATER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn 10 Curb Seplic TaDks From Main 10 Curb
From Curb 10 Bu11d1nsr h'/( ;'1: j" r¿ ~ Electric Pumps From Curb 10 Building
Repair
INSIDE WORK
110.
NEW
USED
NEW
REP. I USED
NO.
NEW
FEES
REP.
USED
FEES
HES
NO.
UP.
BathTub
Garbage Dispoula
Caicb B-
Wub Bubs
Dlsbwubers
Conductors
Wilier CIONt
Laundramll!o
Greue Cllicb BulDs
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BID1I:
Wilier Softeners
Sump Pump II< Ejeclors
Water Hellie..
Sanitary Bubblers
Bar and Soda Wasles
Bho..arBaibs
Urinals
Floor Drains
Dental Cuspidors
Laundry Tubs
Service Sbsb
Inspactions
$:!::f.t)jf..&- - ___.'//;1.27. - - --Outside
....----------......-.-.--------------ooo---m--oooIDBide
Valuation of the Work Herein Described
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$_--000000-'__000_______000_0000000_0000000_--'_-______000000000__'-_000'-
Fee Verified. Receipled and Recorded
Recel:;ð Permit and Inspection F...
_oooooo__ooo:_-~-_oooSewer Fees
_____oo__L.~ooo_PIbg. Foas
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Dale '1-//- 77
e
-----______000____000____000'_____-------______00__--_000__-
----------------------Final OK
City T'....,..
$__--_000_000000000________000__0000000000__000___00_000____-------
In the perfoTmlnce of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to bl bounden by ..,d
submit to all statutes, city ordinances, and rules and regulations prescribod by the Board of Public Works for the government of Plumbers.
II Is futher agreed by the undersigned that no other uses will be made of the above connections except as hereinafter listed.
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