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s �.�.Kt..,�:.,s�9..589 7 „ � � __,,� . <br /> W.u Form J- � <br /> � �CITY OF E�E�ETT--Water Dept. , <br /> Application No..._`_.................. Date___:.:...._::..:..----....'.......::.-�------19---• ; <br /> Install...........`_r:............:inch water service pipe <br /> � ..-.....`..�_.. <br /> For ._.:........._..... .....: • <br /> ........._.-- •..............---"----..._.......___......_..-- <br /> On ...........�./.:::..�.,-.......�...::...:...._:._.:1 Street <br /> . ......- ---........................ <br /> Lot........................_�..........._...--��-�--•--...._:: Block No.._._---•-•---�--�-••-•-----�---._ <br /> Addition ........................._. .....-...._:. <br /> .._.._................--.............................. <br /> Remarks --.........r:..:---............. ....._----- - <br /> -----......----._.._............_-.-... <br /> � . , ., _ , �. <br /> ' ` ` "'""......... _�,..,.._............._.". �..-'1..:L...�..._..._...._.........__'"'_'._._... <br /> ........._. _ _ <br /> : � i <br /> ....�.'..::... !.......� , <br /> .........."'""...................... <br /> -,� 1!_..�.�..._�......._............... ....................._...-----'-'-----'--......_........_._.----- <br /> i ` <br /> . ........................................ ......... ..............�..:..............._.......----��---- <br /> �� �� � Superintendenl � <br /> \ �, � !. <br /> LABOR AND MATERIAI. OSED � <br /> IQo. Sixe i i. <br /> ..................................._.................I Lead Connection Complete <br /> ................._...................................� Sadd7c Comple.e <br /> .......................[t._......_................. ..................................... ..._....Pipe <br /> ........................... <br /> ........................................._........... Servicc Cock <br /> ...................................................... Scrvice IIox <br /> Nn. fiours Labor..............................................Cost......................._.....---................... <br /> Cutin..........._.......Pavement....................X........................ ........................Sq.FI. <br /> ....................X........................ �� <br /> ......._............... <br /> ....................X........................ „ <br /> ........................ <br /> .................._X...........__.._._.. �� <br /> . ......._......__-... <br /> Tntal ......._...............Sq.Ft. <br /> T— . . __—__ __— <br /> �� 1 � �I . • ;� <br /> Ren,arks-�-,--ti......_-,:..... ..__.:,.cc._:.._!.(..:........_................................._. <br /> � <br /> __........_--........................................._...........-� ................................--............ <br /> ................................................................. � ............................--............. <br /> OrderReceived.......... ................._.............................._.,......:...._......=--' <br /> `..." (' •- ., ..�:�j' � ' I <br /> l\'crl. Cempleted.....�..::./ 'J c <: . <br /> t..... <br /> .+:..................:........ ..................:. <br /> Foreman <br />