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� � �� � • / ,r, ) `� <br />✓ <br />V��C;ITY OF EVER� fT--Water Dept. <br />Application No.l..�..I I...l�... Date......!J....... � ............................19...� ./ <br />On L L ..� ... �;T: � ...:. ,/ ... .inch water service pipe <br />For ......,.C....'. / ...................... <br />�sta .... .............. <br />i <br />.2:...... .._.=.'. .�.+... .. . .... ........ <br />✓ I/ <br />.............. .. <br />......._ ... r < < < < . .✓J...{..,.:r. ..� ................ Street <br />Lot..................................._......................`.�Block T <br />: • o ..................................... <br />.Adilition ............................................................. <br />.... ..................................... <br />Remarks............... .............. �..................................................................... <br />// , , � - <br />_ .........................................L.:..�..:i.E. ,.>.s.,f-.s,....t.�.�s...................................... <br />.................................................................................................................... <br />.................. .................. <br />.................................. <br />Superintendent <br />LABOR AND MATERIAL U3ED <br />..........i Lcad Connection Complete <br />............ Snddie Complete <br />........... .........__...................................... <br />.......... Scrvicc Cock <br />.......... Sc:vice Hox <br />........... I ...._.. <br />...........................�.........................i .............................................................................................................. <br />No. Hours L�bor .............................................Cnst.................................................... <br />�/�utin ...................Pavement_ .................X...................... ........................Sq. Ft. <br />G %" t : L _ C ....................X...................... ........................ �� <br />, . :�/ ....................K........................ ........................ ,� <br />Z' S , . , %.; , � � 3 0 �- /�G. X. <br />� ................. ....................... ....................... �� <br />.,- G" ���_,... C' u i- � . � c Total <br />. � f ....................... Sq. Ft. <br />-- ---'-------_-- � <br />/2-'Lz- ,/ -- <br />Re m a r ks ............................................................................................. ............... <br />..................... ........... <br />Order Rrcei�•ed.... <br />\'inr% Completed. <br />_.............'.. / <br />Foremon <br />