HomeMy WebLinkAbout0009627 P
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Date I Lot No. I Block I Ward I Addition or Replat
OUTSIDE WORK
Name
ot
Plumber
NIW SEwn WATER S'ORMS fEES ...S RELAY S, SEWER WA'ER S'ORMS "'s
From MaID 10 Curb ~-JJ (l¿ / '(7/' Seplic Tanks From Main 10 Curb
nom Curb 10 Building /'/l' ) "(1. r7 ~ Eleclric Pumps From Curb 10 Building
/ (
Repair
-
INSIDE WORK
110,
NEW
RIP,
NEW
REP, I USED
NEW
...S
USED
fEES
NO,
REP,
USED
FlES
NO,
BathTub
Garbage DilpoAIa
Catch Bulns
1-
Wuh Buin
Dishwuhen
ConductO"
Water Cloeel
Laundramaitl
Gre... Catch Buins
I--
Sink
Water Softene..
Sump Pump" Ejeclo..
Water Heaten
Sanitary Bubble..
UriDals
Bar and Soda Wasles
Shower Batba
F1oor Drabul
Denial Cuspido..
LaUJIdry Tube
Serrice Sinb
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Valualion of Ihe Work Herein Described
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Fee VerUied. Receipled and Recorded
Received Permit and Inspection Fees
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In Ih.. performance of this work the undersigned owner (or hi, authorized agent) of said preml,es and his authorized Plumber hereby agree to be bounden by and
submit 10 all statutes. city ordinances, and rules and regulations prescribed by the Board of Public Works for Ihe government of Plumbers,
I! Is fulher egreed by the undersigned that no other uses will be made of the above connections except a. here inaner listed.
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