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7104 BEVERLY LN 2016-01-01 MF Import
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7104 BEVERLY LN 2016-01-01 MF Import
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Last modified
5/16/2017 3:12:18 PM
Creation date
1/23/2017 2:18:34 PM
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Template:
Address Document
Street Name
BEVERLY LN
Street Number
7104
Imported From Microfiche
Yes
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- /7,3Zi . � <br />� . o. rn�r a � � � " ��! / �' <br />C:I'i'Y OF �VEfiETT'--Water Dept. <br />:, <br />, . �_,- <br />Application No..���..:1: ��..`j. Date........a?..-.:....s� ... ................._19...... <br />I�stall ..............................inch water service pipe <br />....... ..........................- <br />For ............................................................ . <br />%- l, <br />/C�.�.........%:..:..r.s.c.:Y.�SI......:�.:r.t .:................ Street <br />On.................... ' � <br />• . _ - .... Block No ..................................... <br />Addition .. .................................._... - <br />.................... .......................... ..... <br />Remarks...� ................................................................................................... <br />i............................................................... <br />................. ✓"./� �......................... <br />....................................... <br />j',;........G.-_cI ...,, ... <br />4 .:............. _.....'...c'....'... <br />// - /G - 7Z <br />No. <br />LqgU:. AND MATERIAL USED <br />Lcad Conncction Complete <br />Snddlc Complete <br />Setvicc Cock <br />Service Bnr. <br />No. How•s Labor ............................. <br />Cut in ....................Pevemenl.......... <br />� <br />........................Sq. Ft. <br />......._ ............... �� <br />........................ „ <br />....................X ....................... ........................ <br />�� <br />Total ........................Sq. Ft. <br />�— --"- ---- <br />� <br />. ............----_. <br />OrderReceived ......................................... ..................................................... ( <br />�Vork Comp]r�ted .........................................................................Pureman <br />
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