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. �/ S'�8 S' ����� <br /> W. O. fONM :1 ✓ <br /> CITY OF EVEREfiT--Water Dept. <br /> r � , <br /> Application No..I..��'.:�. .-:. Date..._.....:���.........................19�.:2 <br /> //, /, Insta ............,.,.�. ............ .inr,h water sen�ice pipe <br /> Fer .....lC�,....G:.:. .........:.:-��G�;:i.`.:.... ,7............................ <br /> � <br /> . <br /> � l " <br /> ....... ... <br /> On .............�._%'..�......_G.�: .cc:s�.�..._��:�....... :.cz.:,:�:... Street <br /> Lot........................... ......................��---....... Block No..................................... <br /> Adclition ......................................................................................................... <br /> Remarks ................................... _ . ..........._ . ............... <br /> �..... ... <br /> ..................... <br /> .............................................._�E�.:�1 y�..!. �f�!:............................-•--•- <br /> � � <br /> ._. - <br /> �... ........ .._..��,�:.......................................................................----........ <br /> .....-'-_ <br /> ................. ........................................................................................................... <br /> S� /3 - 7/ <br /> .................................................... ....................................................................... <br /> Superintendent <br /> LABOft AND MATEftIAL USED <br /> No. ' Sixe ( <br /> — -------- <br /> ..................................................._.I Lead Connection Complete <br /> ...................................................... Saddle Co��plete <br /> .......................f t............................ .......................................................................Pipe <br /> .__..................... ............._........... Service Cock <br /> ...........................�........ .............. Seivice Box <br /> ...._......... .._I......................... ......................................_............................................ ......................... <br /> No. Haurs Labor..............................................Cost.................................................... <br /> Cutin....................Pavement....................X........................ ........................Sq.Ft. <br /> ...................:�C........................ ......._............... .� <br /> .... ................ ........................ ........................ <br /> �, <br /> ....................X........................ ,� <br /> ........................ <br /> Total ........................�q.Ft. <br /> -- ------ --- — <br /> Rem arks................................. .......................................................................... <br /> ....................................................................................................................... <br /> ........................................................................................................................... <br /> OrderReceived.............................................................................................� <br /> \Vork Completed............................. .. ........................................................... <br /> Foreman <br />