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I Lot No. I Block I Ward I Addition or Replat
OUTSIDE WORK
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Dale
NEW SEWEI WATER STORMS fEES fEES RELAY S. SEWER WATER STORMS fEES
From MalA to Cub Septic Tanks From Main to Curb
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From Cub to Building Electric Pumps From Cub to Building
Repair
YÎJII 7h / Y~'\ ,./ I::?
INSIDE WORK
NO. NEW RIP. USID flES NO. NEW RIP. USED fEES tlO. NEW REP. USED fEES
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Bath Tub Garbage Diapooals Catcb Bulns
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Wuh Buin Dishwuhan Conducton
- - - - -
Waler CIOl8t LaundrIUD8Ù Graue Catch Bulns
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SIDk Water Softenen Sump Pump II< Ejectors
Wale. Haatan Sanitary Bubblers Bar and Soda Wastas
Sho",.. Baths Urinals
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noor Dr8lsuo Dental Cuspidon
Laundry Tuba Service Sinks
Impactions Valuation of the Work Herein Described Fee Verified, Receipted and Recorded Received Permit and Inspection F-
----._-----------------------------__--Outside $-----______5~-=o.Q__:=:~------------------------- l:i:;::.--:~~r F:7
--------------.-------------.-------------Inaide
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-----_._------------~inal OK $- -- - ------- -- -------- --.._---",,----------------- Date /0 - V-- 7¿
In the performance of this work the undersigned ownar (or his 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 prescribad by Ihe Board of Public Works for the government of Plumbers.
II Is futher agreed by the undersigned Ihal no other uses will be made of the above connections ex
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