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I Lot No. I Block I Ward I Addilion or Replat
OUTSIDE WORK
17
Date
NEW SEwn WATER STORMS lEES FEES RELAY S. SEWER WATER STORMS FEES
From MaIn 10 Curb Seplic Tanks From Main 10 Curb
him Curb to BuDding Eleclric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO.
NEW
RE'.
NEW
RE'. I USE'
FEES
FEES
NO.
NEW
RE..
USE.
USED
HE.
NO.
BathTub
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./
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Conduc1o"
Garbage D~
Catch BuIDa
Ii
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L
L
Wuh Buin
Dishwuhero
Gre... Catch Buinl
Laundram&18
Water CI_I
f-
/'otJ
tt
BIDk
Water Sofiene..
Sump Pump 8< Ejeclo..
,/
Bar end Soda Wasle.
Water Heaten
Sanitary Bubblen
Shower Baths
Urinals
dL¡;<,,-i!ørR£
noor Drlllu
Denial Cuspidon
Service Sinks
Laundry Tubs
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In the performance of this work the undersigned owner (or his authorired agent) of said premises and his authorired PI~mber here~ be bounden by end
submit to all statutes, city ordinances, and rules and regulations prescribed 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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