HomeMy WebLinkAbout0009516 P
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I Lot No. . I Block I Ward I Addilion or Replat
OUTSIDE WORK
Date
NIIW SEWn WAtER STORMS FEES FE" RElAY S. SEWER WAtER STORMS FEES
From MaIn 10 C\U'b Septic Tanks From Main 10 Curb
~ C\U'b ID BuDding Electric Pumps From Curb 10 Building
Rep8ir
INSIDE WORK
NO.
NEW
II'.
NEW
NO.
FEES
REP. I USED
FEES
NEW
REP.
USID
USED
FEES
NO.
Bath Tub
Garbage DilpooaIa
Catch Bains
I--
Wub Bain
Dishwahen
Conduclors
I~-
Water CI_I
Laundrama.18
Greue Catch Bow.
f--
Sink
Water Softeners
Sump Pump III: Ejectors
Water Heate..
/
Sanitary Bubblers
Bar and Soda Walles
v<>z!
Shower Baths
Urinail
noor Dr8IDs
Denial Cuspido..
Laundry Tube
~:~:..................................Ouilide
Senice Sinks
Valuation of Ihe Work Herein Described
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S...........................................................................
.
Fee Verified. Receipled and Recorded
Received Perml! and Inspection Fees
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~ 3- 7.6
..........................................................Inoide
.....................................................
..........-...................--Final OK
s
C;ty T,....,.,
Date
In the psrlormence of this work the undersigned owner (or hi, authorized agent) of said premises and his authorized Plumber hereby agree to be bounden by and
submit to all statutes. city ordinances. and rules and regulations prescribed by the Board of Public Works for the government of Plumbers.
II Is fl/!!1er agreed by the undersigned that no other uses will be made of the above connections except IS hereinafter listed.
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