HomeMy WebLinkAbout0008232-Plumbing (water service)
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I Lot No. --I Block I Ward I Addition or Replat
OUTSIDE WORK
Date
NIW SEWEll WATER STORMS .... "'S RILAY S. "WER WATER STORM' FEES
From MaIn to Curb Septic Tanks From Main 10 Curb
From eu.b to Building Electric Pumps From Curb to Building
Repair wo.f¡, AM..J ' ,../
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INSIDE WORK
NO. NEW UP. U"" RES NO. NEW REP- USE. FE" NO. NEW REP. USED ....
- - - - -
Bath Tub Garbage Diopoeak Catch Basins
I--
Wash Basin Diobwuhen Conductors
- - - - -
Water CI_t Laundr1UM.!8 Grease Catch Basins
SInlI: Water Softeners Sump Pump 8< Ejectors
Wilier Heaten Sanitary Bubblers Bar and Soda Wastes
Sho",... BIItha Urinals
Floor Drmlu Dental Cuspidon
LaUlldry Tubs Service Sinks
Inspact1ons Valuation of the Work Herein Described Fee Verüie<L Receipted and Recorded Received Permit and Inspection Fees
-------------------- Outside $_-_----L,;}___:::'_..------------------------------. ---------------------Sewer Fees
--------------------___--......Inside ----/..-~.._--'p1hg. Fees
=-31Ø$.5._-==~~ 0; $-----------------------......-..--..---....----....------- ----/--~-:::_--- Total
$-----------..------..--....--..-----------..---- ""---------------------cliÿ-r;;;;ü;'-;-------"-------------- Date -s/- / V'~ ~
In the performance of this work the undersigned owner (or hi, authorized egent) of ,aid premis., and hi. authorized Plumber hereby agree to be bounden by end
submit to ell statutes, city ordinanca., end rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
It Is futher agreed by the undersigned that no other uses will ba made of the above connections except as he"inaft.r listed.
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