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127 DORN AVE 2016-01-01 MF Import
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127 DORN AVE 2016-01-01 MF Import
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Last modified
4/10/2017 10:27:34 PM
Creation date
2/12/2017 3:33:20 AM
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Template:
Address Document
Street Name
DORN AVE
Street Number
127
Imported From Microfiche
Yes
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/S/o3 ���s�,� <br />w. o. rcn.. c <br />(�ITY O� EVE"RE1'T--Water Dept. <br />Applicnlion No.I.'��Ll!>,.� Datc.......�.:J. 4 -7 <br />............................19..... . <br />�/stall .............�...�... .......... .inch water service pipe <br />For......�....:?�-..Y./._. ....���Is' ....................................................... <br />On ......�_2..7.........-C.� i:tt..1.._�� ......................................... Street <br />Lot.............................................................. Block No..................................... <br />�dciition .......................................................................................... <br />................ <br />Remarks....................... . . ............. .. . . . . . <br />. .. .. . .. <br />...... .. .... <br />... .... .... ... ...... ... . .. .... . .. <br />.................................r...... .:.� .��:x�3.yC�:.:. s:�c%...................................... <br />, <br />:.._ ...:...:................ ............................................... <br />� �. . .......................•-............... <br />__ // l <br />j . _..: ...! ..:........................ <br />................................... ............................................ <br />. ...........::.,.. ,�............................................................................... <br />�� J� / / Superintendent <br />LABOR ATD MATERIAL USED <br />Lead Connection Complele <br />Saddic Complete <br />... ....................................................................PiPe <br />Scrvice Cock <br />Setvicc Box <br />No. Hours L�twr .............................................Cost.................................................... <br />Cutin ....................Pavement....................X................. ..... ........................Sq. Ft. <br />: 1 <br />/ ; ; � ....................x........................ ...... _.............. „ <br />, <br />, r �;,, � <br />i � <br />, , , y . ....................X....... <br />......._..........X... ........................ <br />. � ' .� ;+,' . . Tolal <br />�;� — � . � ........................Sq. Fl. <br />.. .............................................................................................................._....... .. <br />OrderRecei:•ed ..............................:............................................................... <br />\Vork Completed ........................................................................................ .. <br />Fareman <br />
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