HomeMy WebLinkAbout0009809 P
~
)
,)
N-
of
PllUllber
~PŽB:;Z¡~:h:~~::::;~ _&Jß~
I Block I Ward
I Lot No.
I Addilion or Replat
Date
OUTSIDE WORK
NOW SEWEI WATER S'OIMS FEES FlES IILAY S. SEWEI WATER S'OIMS FEES
From MaIn to Curb Septic Tanks From Main to Curb
FIom Curb to BuDding /f/rY£ I /J bJ) iJrÏ'zv Electric Pumps From Curb to Building
Repair
INSIDE WORK
NO.
NEW
USED
NEW
FlES
NEW
FlES
IEP.
USED
HES
NO.
REP. I USED
NO.
RIP.
Batb Tub
aubage Dis»DA1s
Catch Basins
1-
Wash Basin
Dishwashers
Conductoro
Wilier Cl_t
LaundramIIiJI
Grease Catch Basins
~L
SIn1o:
Wilier Softenero
Sump Pump 8c Ejectoro
Wmr Hellien
Sanilary Bubblers
Bu and Soda Wastes
Shower Baths
Urinals
noor DraIJIs
Dental Cuspidon
LJ-,
1---1 -
Laundry Tubs
IupedÏons
Service Sinks
Fee Verified. Receipted and Recorded
Received Permit and Inspection Fees
.3".0--.0---.s.wer Foes
. ~..ó..~L..plbg. F..s
N....'!jL.'-OlJ.... Total
Date /02.,17. Î Co
.....---..........-......-....---......... ...........Outside
............................---.......---.................Inside
Valualion of the Work Herein Described
$ .. ...~-<:J!..~---.~.............................---....---..
$.------...------............---..-------..-...............................
$..........---..----....---........------....---............---.......-....
City "....",
7771zrll.."Þ::=~'::::::::::;~---~-;
....---....
..........---..............................---.........
In the performance of Ihis work the undersigned owner (or his authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by and
submit to all statules. city ordinances. and rules and regulations prescribed by the Boord of Public Works for the government of Plumbers.
It is futher agread by the undersigned that no other uses will be made of the above connections.. except os hereinafter listed.
~73J~~~~:~.' ~~¡ ::..:.....:: ............. """""------..