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\ <br /> , ` � <br /> W.b.Foem 3 I(CV I1.10.t1 � � �'+����:'• .. <br /> . . ''ulT�.�. �� '-�qp�:_,.., <br /> CITY OF E�� �RETT-•.Water Dep� <br /> APPlitation No.A..�..I $... .. ate.. ���1� 192� <br /> _,.. <br /> �� <br /> Install �p��, ?' �-i�nch water service pipe <br /> Fot ... ._ _ � _.V P. ��J�w'�-�. <br /> -� 0� � r Jcf_r_'�- <br /> On .... �� �—!-<-'+.�1.,s--�af'� U -'.. Street <br /> Loc. ....... . .... �_�. _.__Block No... � o `a <br /> . . .. __. <br /> Addition_..................._.................... ._............_................... ........................... ........... <br /> Remnrks........................................__.............._........... ...... ..................................__,.......... <br /> _ . _...._....................................._......_ _......_- ..........................._.._....._............ <br /> _...............__... .._.................. ....................._........... ....__._. __..........._ _........._.. <br /> .._.................. .. ....................__ ................_.. ..__ _..__..._ ... _... _. .............. <br /> �._�..._.1�?.-< ..��.ry,,� <br /> ....... .... <br /> v rint� <br /> __ _ . ._---_' <br /> _— .___— _---"--'--_--_—'_'._—_.---_—__--'_ _ <br /> LAUOR AND \IATPRIAL USI'sD <br /> ---------- — � -- - -. ._ .- ----- - . . . _._- . <br /> No. Size <br /> / —. ... ?�. �' - __.--__. — _- .__ '_ <br /> I � I <br /> ��-���•�-�•������ . Lend Connection Cc.uplete <br /> ..........1...............�.._.j�...K.��..._. SnJdle Complete <br /> . ._._..:r..�...... .� ...'.�.'_!{,i:.t.'.:.........................._Pipe <br /> ......./..C..........fl.l . . <br /> ..........�...............� . .d<......... Scr��ce ock <br /> ..........L...............j...:�ranC��� c ,T. �e�e��d,,y <br /> c .. � <br /> ..........,! ...................R.'..... ..._ . .a1.�.�.Y�:..//l[:�E^l�..........................._................................................... <br /> ^; • .. � . � � <br /> .... .._:............... ......�.?'.........._. Q�.,�..��.(�.i:�a,..................................................._......._.......................... <br /> ........._�:........... .. .v.._....... c.G'Cl�.a::.�../..'. . .... .... ............... ........... . <br /> ..........�....__.. . ...�J".�.. . . L.�/tf<Q� . V.".2-�x'£.- ................ <br /> � p _ <br /> .Y —.L—� � �__LL��_ �__ ___�. J G --_ ___--_' <br /> Nu. Hours LaUor...........Q......................Cost......�._...-........................................ . <br /> Cut in.........1_...... � ' <br /> ......I'nvemenk��;�.�nc�h............_......... .....Sq. Ft. <br /> . .. ............ <br /> ' ��.X.'.��..�....X........................ .... ,� <br /> „ ................ <br /> ....................X........................ �, <br /> , .................... <br /> � ....................X.__....,............. ,. <br /> ........__.._ . . <br /> Total ...................Sq. Pt. <br /> `--_—= _�-- - - - '�_/ � -- �� <br /> Rem�rks lEi .rt:it.: �it, � ..K�fJ�J_!•-�1 rJ,!- ---_-- <br /> e�t�f.�, �,�.s::�x� _ <br /> _..._.___ _.__ � .. _ <br /> __ ...... <br /> _ _.__ _ _..._.. <br /> Ordcr Rcccivcd .. ��i �' f�'� , <br /> � <br /> Work Completed _ _ _ _.�� �� . C� � <br /> Fo�m.� <br /> , � % <br />