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F I O�M l ��� 7 • _ ' I l. <br /> -CITY OF EVEF�E:'IT'..VUater Dept. <br /> ApPlicnti;m No..�...'._d...:( %; Datc.._... ........:! . <br /> ..........:....................19....:: <br /> � � Inst•.:�..... ...._...................i�ch water service pipt <br /> _ � <br /> l or ' <br /> ......._....:.. .- <br /> ......_ . _. .C...' /.........d.:...... . <br /> .. <br /> . - -�� ................. <br /> .......... ......... <br /> n .........__.:._.�:.... ' . � ' . . <br /> __...._........................._ _. . .. ...._:..... Street <br /> \ ... .. <br /> I.or__ .�.rx.�.....{�.;..._l...f:�:,.c��t..� Block No..................................... <br /> Ad�lition <br /> .... ........................... . <br /> __........... <br /> Rrmerks / T........................................ <br /> _........................ . <br /> 4• ...u...........n.....1....A: <br /> . ........................................ <br /> ............... .. <br /> .................................................................................... <br /> ................. <br /> .....................................................................�................. <br /> ........................................................ ......................... <br /> .. ................................................................................ <br /> Superintendent <br /> �-_- —_=�_�- _, <br /> LAROR ANp MATERIAL USED <br /> Nn. ' Sfzc i <br /> .� . ... ..� . I *r:�d Cnnnection Complele - <br /> ..-.-- . SnddleComplele <br /> ._. . ................tl................._......_. <br /> .. ..._ _. .........Pipe <br /> ._........_.___..............__............ <br /> ...._....................._.._.................... Scrvicc Cock <br /> ..... ....................._...............,. Servicc Box <br /> ............... ................ <br /> .........._.................. <br /> �� _....__........ -�� <br /> .-�.�:_.. .................................. <br /> No. Ilours L�boc._...__.............__.................CoaL................................. <br /> Cul in_. ._.___. _.Pnvement .__......... � ................ <br /> .__ X....................... <br /> ...............__.....Sq.Fl. <br /> ....................X........................ �� <br /> ......._............... <br /> ._ _.._..........X................_...._ �� <br /> ............. .......... <br /> .._....... ........X...................... . ,� <br /> ........................ <br /> Total ..._.....Sq.Ft. <br /> -----` ............. <br /> .._ ._.—:-- <br /> �- ----'�—_--_ <br /> -._: <br /> __ --_ <br /> e i n a r k s.............. ... ................... � <br /> ..�................................................. ................................ <br /> .. ................................................................................................ <br /> Order Reccived ...._...... <br /> ..................................................... ... <br /> ............. <br /> \Vork Cnmplcted_ ... ..._......... <br /> __ _ . _. / <br /> _ . _ . <br /> __ ..__....._ <br /> Fnreman ' <br />