Laserfiche WebLink
W. - D. FORM J50*720 <br />CITY OF EVEREFT—Water Dept. <br />Application Date..........S . ... / .......................... <br />Install...- ......inch water service pipe <br />For.. ....... ... ......... . ............... ..... <br />On....... ...... : ............. ... .. ........ .. . ... ... - ........... ........... ........ Street <br />Lot................ .............. . ................ . . . .. Block No........_.._..._.._.._..._... . <br />Addition............................. ... ... ........ ............ ......... <br />Remarks............................ azr.,t:t�. f .. . i.i. . .......... . .. ........ ......... <br />Superintendent <br />LABOR AND MATERIAL USED <br />Lead Connection Complete <br />Saddle Complete <br />.................... .......... .. . .......... —._...__..Pipe <br />Service Cock <br />Service Box <br />No. Hours Labor ........................ .. ........... ...... Cost. ........................... ................ <br />Cutin ....................Pavement..............._.. X ...... ................ ................ .... Sq. Ft. <br />.................... X .. .... ............... ...... <br />........ ....... ... X ........................ ....... ................ ., <br />Total ........................ Sq. Ft. <br />Remarks......... ....... .... ......... ......... . . ........... ... ........ . ........ .... .... ......... <br />.............I....... .­ __ <br />....................................... . ................ ......... I ..................................... . ... <br />OrderReceived ......................................... . ................ ........ .... ................... <br />WorkCompleted ......................................................................................... .. <br />Foreman <br />