Laserfiche WebLink
■ <br />7 ��' �' � ' <br />B. J. PRICB[ 9M ti.� :.� ` <br />w.O.�ORM] ,3� � -� <br />CIT �' UF E'JERETT--Water Dept. <br />Applicalion No..`:.�.��.. z. r?:.. Date ................ .!I.:�.��..—.:.(..._19._� / <br />Install ............................. .' ch water service pipe <br />For.................................... ............. . .................................................... .. . . . <br />� �y . ... <br />On ..._?�:n.�.._��.._�..�t(1........'t/,.�C�> ..................................... Street <br />Lot............................................. �---............ Block No. ...........---........---�--�----�- <br />Adclition ................. ........................ <br />� ......................................................�-� <br />Remarks...................................................................................................�--�-- <br />............................. ...... <br />................................. <br />............................. ............. ............................... ................................................ <br />Superintendent <br />LAliO$ AND :HeATERIAL USED <br />Size <br />Lead Connection Complete <br />3addlc Complete <br />........................................................................ P i p e <br />Service Cock <br />Service Box <br />................................................................................. <br />... .................................................. .......................... <br />....... .............._...I ..........................I ..... <br />No. Hours Labor ..............................................Cost.................................................... <br />Cutin ....................Pavcmcut..........._....._X............_.......... ...................._.Sq.Ft. <br />....................X........................ �� <br />........................ <br />....................X........................ ,� <br />........................ <br />....................X........................ „ <br />........................ <br />Total ............._.........Sq. Ft. <br />-- ----'--------- <br />---- <br />Remarks ................................................................................. _..... .................... <br />...... _ ....................... ......... ................... ................_........................................... <br />OrderFecei�•ed .............................................................................................. / <br />�Vork Campleted ........................_ .............._.........._.......... ...._............._. <br />Foreman <br />