HomeMy WebLinkAbout0000000-1978
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I Lot No. I Block I Ward I Addition or Replat
OUTSIDE WORK
Dale
NOW SEWEI WAtER STORMS FE" filS RELAY S. SEWER WATER STORMS FEES
From MaIn to C....b Seplic Tanks From Main 10 Curb
From C....b to BuDding Electric Pumps From C....b 10 Building
Repair
INSIDE WORK
NO.
NEW
"P.
FEES
USID
NO.
NEW
REP. I USED
FEES
><0.
FEES
NEW
REP.
USED
BaIh Tub
Gorbage DiIpoqIs
Dishwashers
Caleb Basins
L
L
---!---
I-
f
L
1"/
r'
(/
(r~
Urinals
,/
Conduclors
Wub Basin
../
v
Laundramaltl
Greue Caleb Basins
Waler Cl_1
f'-
Waler Softeners
Sump Pump 8< Ejeclors
SWk
.......-
,/
Sanilary Bubblers
Bor and Soda Welles
Waler Healers
Shower Ba1h8
Floor DraIDs
Denial Cuspidors
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Laundry Tubs
Service Sinks
IDlpedions
Valuallon of the Work Herein Described
$Jd,æ:p~-----------------------------_.-----
$--- ------------------------------------------...----------------.
$------------------------.------ ------------.---------------------------
Fee Verified. Receipled and Recorded
Received Perml! and lnspeclion F...
---------------------"h---Sewer F...
--,á~_é'Q-------Plbg. Fees
D~~':~-~~/:
--~--:,;:.::?---7?";,--~_:;:/Outside
¡¿t:::l--... 7'--~~ ;7K._----- IDllde
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---------C¡;:;-T;;;~;;.;--------------------------
------------------------------Final OK
In the performance of this work the undersigned owner (or his authorized agent) of said premises and his authorired Plumber hereby ag~a 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.
ierslgned that no other uses will be made of the above connections except as .hereinafter listed.
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