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w. o. r�� �� / � , . <br />� 'CITY OF EVERE7PI'--Water Dept. <br />Application No./�.._'c.. L.�L�.. Date..........:)......1. � <br />.........................19..:.:. ; <br />/� lnstall .. ........................... inch water service pipe <br />i � / <br />For ._. C.._:....r:(...._........ L._(... � <br />_...._. , .................. . <br />...._ ...................... .. . .. <br />... <br />O„ ........ .. �.._L....c :..:. :..............�:.:..............::. <br />................:............ Street <br />Lot.............................................................. Block No..................................... <br />Acldition............_............_ ........... .:. :........................... <br />................................ <br />Remarks ............. / , <br />..................( _ , „ <br />�.........-•-.......I ..:................................... <br />�, �l�P L� ....... ..................................................................................... <br />............................... ........................ <br />�...-...�...-.�..9 ............ ............................................ ....................... <br />........- - - <br />................................ ............................................ <br />Superintendent <br />[.ABOR AND 11iATF.RtAL USIiD <br />aizc i <br />__-_. '-..___I______.._ <br />........-............ .-.I :.cud Cnnnection Complelc <br />... . .................. <br />_._ ......................................_.........I S�ddlc Cornplcic <br />.... _ _ ..............St. ................... _... � <br />. _...__......_...._ ............................__...............Pipc <br />...................... ...�..�......��...�....i ��ervicc Cock <br />�•��-�� Sc�-:icc IIax <br />. . ...... .. ...... ...... <br />Nn. Hours L:,bnr ._...__ ... ............._........._ .Cost.............................. <br />Cut in........_.. _ I'avemcnt .................... <br />__.__..........X.._ .............._.... ...................._.Sq. Fr., <br />_..__............X ............._......... �� <br />........................ <br />.....__..._...X ........................ �� <br />........................ <br />. . _.._.......X ........................ �� <br />...................... .. <br />-_---�----------- Total ......Sa.Ft. <br />� - - -- .................. <br />, _ _ --- — <br />— ---- <br />P.emarlc,. _. .. - <br />............ _... ...... . _....... _.. _ ... ..................... <br />_ ........ ..... . .... _ _..... <br />.................... <br />..................................................................................... <br />Order !tecciecd_ ._..... _.._. ..... <br />_.. .._ .... ................ <br />...................... <br />\Vork Cnmplcted _ _._ <br />_._. _ . <br />__.. . _ __ .._.__...._...._ .. <br />Foreman <br />