HomeMy WebLinkAbout0008798 P
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I Lot No. -I Block I Ward I J\.ddilion or Replot
OUTSIDE WORK
Date
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NIW SEWER WAIER "ORMS FEES "'$ RElAY $. SEWER WAlE. $lORM$ FEES
From MaID 10 Curb Seplic Tanks From. Main 10 Curb
From Curb to Building Electric Pumps From Curb 10 Building
Repair
INSIDE WORK
NO. NIW REP. USED RIS NO. NE'" REP. U"O "'E NO. NEW REf. USID FIlS
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Bath Tub Garbag&DIopooa!s -- Catch Basins
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Wuh Basiø Dishwasb..... 1- Condudo,s
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W- CIOI8I LaundrLUDats G~...... Catch Basioa
Sink / /¡JL() Wate~ Softe"e.. Sump Pump 81: Ejsclo..
Wato~ Heate.. Sanitary Bubble.. :9.. and Soda Waslos
SlI.o..... Batba Urinals
no.... DnIu Dental Cuspldo..
Laundry Tubs Service Sinks
IDlpedlolIS Valuation of the Wo.k He.ein Described Fee Verified. Receipted and Reeorded Received Pe.mit and Inspection F-
- 0'"
--.------.--------.---Outslde $--_._---------j~-.Q--_:~----------------- ------._----------.--Sewe~ Fees
--.------~--_._----.---.-IlISlde ___I";;;___-Plbø, Fees
------77!i-Zj------ $-.------------------------------------------------------ ._-_.L_--------Toíal
-- --~ t;22--------F1llal OK $---------------.----------------------------- --------------"-------cl¡Ÿ-T;;i;.~;;;;----------------------. Dote 1/-,2ý'- AS
In the performance of this work the undersigned owner (or hi. euthori.ed agent) of ..id premise. and hi. authorized Plumber hereby agree to be bounden by and
submit to all statutes, city ordinances. and rules and regulatiens pre,cribed by Ihe Board of Public Works for Ihe government of Plumbers.
It Is futher agreed by the undersigned that no other uses will be made of the eb."e connedion. excopt as heroinafter listed.
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