HomeMy WebLinkAbout0000421-Plumbing (laterals)
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Plwaber
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I Lot No. .---- ------ _I_Block I Ward I Addition or Replat
Permil N? 421
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Dale
OUTSIDE WORK
Naw SEWEa WAIER STORMS FEES FE" RELAY S. SEWER WATER srORMS FEES
From MaIn 10 Curb Seplic Tanks From Main 10 Curb
From Curb 10 BuDding J./-" c-/ 11- 'G ~ Eleclric Pumps From Curb 10 Building
I Repair
INSIDE WORK
NO.
NEW
UP.
NO.
NEW
FEES
REP. I USED
FEES
NO.
NEW
REP.
USED
USED
FRES
Bath Tub
Garbage DiopoIals
Calch BulDs
Wub Bum
Dlshwuhen
Conduclors
WaiN CI_t
Laundramaio
Greua Calch BulDs
Sink
Waler Softeners
Sump Pump 8< Ejeclors
Waler Healen
Sanitary Bubblers
Bar and Soda Wules
ShoWN BaIhs
'I1rina1a
Floor Dralna
Laundry Tubs
Denial Cuspidon
Service Sinks
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Valualion of Ihe Work Herein Described
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Fee Verüied, Receipled and Recorded
Recei~ Permit and Inspecllon Fees
...----.---:-:=":'----_Sewer F-
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---------1!.-~----Tolal
t".,;2/n-:77
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Date
In th. performance of this work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by ..,d
submit to all statutes, city ordinances, and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
" Is futher agreed by the undersigned that no other uses will be made of the above connections except as here inaner listed.
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