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DId8 L~otNO' I Block . I Ward I Addition or Replat
OUTSIDE WORK
NEW sown WArER STORMS FEES FE" RELAY S. SEWER WAIER srORMS FEES
From MaIn to Curb -h Seplic Tanks From Main to Curb
Ftom Curb 10 Builcllng ..zj II 7 j,/ ~ 0/.11) Elactric Pumps From Curb to !3uiJding
,~ Repair
INSIDE WORK
NO. NEW UP. USED FI.. No. NEW R". U,"O FEES NO. NEW REP. USEo FEES
- I--- -
Bath Tub Garbage DÌI~ i- Catcb Bum.
- -
Wub Bubs Dilbwashera Conductors
- -
Wate Clout Laundr- Grease Catch Bulxss
Sink Water Softeners Sump Pump 81: Ejedors
Watu Heaters Sanituy Bubblsrs Bar and Soda Wutes
Show. ,Baths Urinals
Fl- Drlllwl Dentai Cuspidors
Laundry Tubs Service Sinks
Inspectio... Valuation of the Work Herein Described Fee Verified. Receipted and Recorded Received Permit and Inspection Fees
-~._--_._-----_. ----Outside c:¿~() ~ êfcKJ
$-----------------__----_m___-_-m______---------------- ----I ¿;:v-----mJ!ewer Fees
--------------.----___--Inaide ------------------PIbg. Fee.
=~~2~r-~ 0; $--- ------ ---_..-- ------------ -----m--____m__---- -----:'l'...~--__Tota1
$-------------------------------------- -----------------------cliÿT~;';~~~;--------------m. Date ~--c2;)- 15
In the perfor",ance of this work the undersigned owner (or his authori.ed agent) 01 said preml.es and hi. authori.ed Plumber hereby agree to be bounden by and
submit to all statutes, city ordinances. and rules and regulations prescribed by the ~oard of Public Works for the government of Plumbers.
It I. futher ogrled by the undersigned that no other uses will be made of the above conneetlons except .s hereinafter lisled.
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