HomeMy WebLinkAbout0009414 P
~
)
B-
ot
Plumber
~ ~ * - P Z B I &: I ~ =;: n :it - QL1: ~ ~
I Lot Bo. I Block I Ward I Addition or Repl81
OUTSIDE WORK
Dale
NOW SIWEa WAtER STORMS FEES FEES RELAY S. SEWER WATER STORMS FEES
From Main 10 C...b Seplic Tanks From Main 10 Curb
........ C...b 10 BuDding Electric Pumps From C...b 10 BullcUng
Repair
INSIDE WORK
NO.
NEW
1-
~
;;2....
7
~
REP.
NO.
NEW
FEES
REP. I USED
FEES
NO.
NEW
REP.
USID
USED
FE"
7
J)5(
l, ð òi
'~ðò
::kou
~/'.~~
.'10
.r)D
C8Ich Basins
BaIh Tub
Garbage DiIpooaIs
Dishwashers
Conduclo"
Wub Basin
7
r-:---:-
I~()
/P~
Gre.... Calch Basins
Laundram818
Waler CI_I
Sink
Wain Soflena..
Sump Pump &: Ejectors
/
Sanilary Bubble..
Bar and Soda Wasles
Walar Heale..
Shower BaIhs
Urinals
Denial Cuspido..
Floor DrÚIIS
Laundry Tubo
Inapacliona .
--"----------q-I--------t--n"'r----_--_Oul8ide
-----....-----------\--f.3-:- --I--J..D--_-------Inaide
=~ :=~!¡;ir(:fj==:;;::;~;
Service Sinks
Va~l}on of the Work Herein Described
't:fiJ/6 00 r 61>
$--------;/-------------------------------------------------------...----
Received Permil and Inspecllon F...
i¥P:~ß::Q::::n:~r F:-:
D~~/t;7:;~ ç;
Fee Verified. Receipled and Recorded
$------...--------------------------.--.-----------------------------------
$--------.--------.------------------------------.------------...---
-"-----"-"--------------é'iiÿ--T,..;~;ë;--------------------------
~4_:-~T~;~~,~~::=~t::--_::::::_-::-------:------::----:-------
In the performance of this work the undersigned owner (or his euthorired agent) of said premises and his authorized...-PIymber hereby agree to be bounden by and
submit to all statutes, city ordinances, and rules and regulations prescribed by the Soard of Public Works for the gover,,6iant /of Plumb
It Is futher agreed by the undersigned that no other uses will ba made of the above connections except as herein