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w`u.'ron�� I �V � • � • � —_ . .i,' /!� ,i � <br />�/✓ <br />� -EITY OF E�ERE�`1'--Water Dept. <br />Application No...._l_:�::,r..:!.✓ Date ................... i. <br />........................_ 19.... -� - <br />Install ...............................inch water service pipe <br />For ........................ <br />...................... ................................................. .... . . . <br />On ........._��/:.....i:........,!�::.r.�_:..<.l.. �.: .... ... <br />�..._...:..1t.:,...:ti� .................. Street <br />Lot_ ......................................................._... Block No..................................... <br />Adciition ........... <br />..................... . <br />. ................. ......................................... <br />Remarks i, "..... <br />............_. , <br />. __...:_�t..... �. ...................................................... <br />_ .......................... - - <br />,. ................................... <br />� �' <br />. .1......!..(1_.._.I/ —/ - <br />.......... .......................... <br />_..... _ .................................. <br />... <br />Superintendent <br />---_-__ --____--- _ <br />LAHOR AND 117ATERIAL USED �_— <br />--- No.__j Size i . <br />....................._ .............__...........I -- <br />� ' ..ead Conncetion Complete <br />....................................................... 8addle Complete <br />....................... t t. ................... <br />........ ....................................................................Pipe <br />....._ ................... . ............. Scrvicc Cock <br />........................... ....... ....... <br />���������•�� ervice Box <br />......................... <br />- ---......... <br />No. Hours Labox ............................... <br />............... C o s t.................................................... <br />Cut ia.__ ............. Pavement....................X........................ <br />.........__...........Sq. Ft. <br />....................X........................ „ <br />........................ <br />....................X........................ , <br />........................ � <br />....................X........................ :, <br />__�. <br />_ ----- --�`—_----� Totnl <br />-- ..........._....._...Sq.Ft. <br />— -- <br />--__--- = <br />emar s ......................................................................_............. <br />........................ <br />..................................................................... <br />............. .................................. <br />... . .............................................. <br />Order !?eccieed__ ...................__......................_........................................... <br />1Vork Complcted....._ .............._........_.. ... . <br />....... ....... ........... . . ) <br />Foreman ] <br />