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I Lot No. I Block / 'I Ward ~l Addition or Replal
OUTSIDE WORK
Dat.
NIW SEwn WATER STORMS FEES FEES RElAY S. SEWER WATER STORMS FEES
From MaIn to Curb Seplic Tanks From Main to Curb
From Curb to BuDding Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
UP.
USED
NO.
NEW
REP. I USED
FEES
NO-
NEW
USED
FEES
REP.
FEES
1
-/
y/
I
/
.,/
,/
./
./
./
V"
-1-
.,/
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1/. ad
j,UIJ
,-I¡,tfl)
/ø
Bath Tub
Garbage DilpooaIs
Cùcb BulDs
~'Oðl
,or; I
.0' /
i,OV
¡, 0-0
Wub Buin
Dilhwuhen
Conductors
Greue Catch BulDs
LaundrllDllltR
W- CI_t
L
Sump Pump 8< Ejectors
/'
SIDk
Water Softeners
Sanitary Bubblers
Urinail
Bar and Soda Wut..
Water H.at.rs
Shower Baths
II. 00 ï
Dental Cuspidors
/
noor DraIDs
../
Laundry Tubs
Service Sinks
Inlpecti. Dna Valuation Of2::hð rk Herein Described Fee Verified, Receipted and Recorded Received Permit and Inapeclion Fees
------------------------------------t-___n __Outside /'-----de) 0 .--_.n.-------------~---_._Sewer F...
U /'..c Í-. ¡:C¡ jo 1 q 177 . $J~""'_--------n __---_nn---_------~_------------------------"'--- I:!, 0 D
.-- - __ŒL.-1---- -_...------- - -- - --t-i--I-__f1nl,de --- ---...__..--nn------_PIbg. FHS
~=41~---¡;7:¡¡!=~~---;;;' -- ::~::::::::_:::::::::::::::-:-::::::::::~:::::~:-:::::::::::::::~::: -- n_-----ëííŸ-T;;;;~;;;n______------------------ D~:~~-~;-;h 7'
In the performanca of this work tho undersigned owner (or his authorized agent) of said premises and his authorized Plumber heroby agroo to bo/ bouri'don by end
submit to all statutos, city ordinancos, and rules and ragulations prescribed by the Board of Public Works for th~mont of Plumbors,
tho undersigned that no other uses will bo made of tho abovo connoctions except