Laserfiche WebLink
_ . ��L (� �. -,- • �� / l-�i c <br />w. o., ro h a. • - ` <br />` CIT�Y C7F EVE[�EiT--Water Dept. <br />Application No.=::`.-'_l.i... Date ................................................19...... <br />. <br />Iastall ...............................inch water service pipe <br />For............. ...................................................................................................... <br />..� .� ' _,- . ' <br />On ..._ ................... 3.t,....�::n ::i �;.-;:.. Street <br />. ,.,�..._ ....................-------� <br />Lot......... .................................................. Block No...----.............................. <br />�d�lition ........................................................ ............................................... <br />Remarks_..l�c:.�_:<.:,:.��r.. ....................::::.....................................-- <br />�.: , <br />.. .... ..................1 .1..... �......................... <br />' + �' <br />..�./........:.'� ..... .....:......:............................ <br />I.ABOR A1�D MATF.RI.1L USED <br />Na. � Size I <br />Lend Conneclion Complete <br />S�ddle Complete <br />.................................................... <br />Service Cock <br />Service Bnx <br />� <br />Nu. Rours L�bor ..............................................Cost.................................................... <br />Cut in_ .................PaSement._.................X........................ <br />........................Sq. Ft. <br />....................X........................ �� <br />........................ <br />....................X........................ �� <br />........................ <br />....................X........................ �� <br />........ ........ <br />Tolal ......... .... .. Sq. Ft. <br />'—_ __.__.____—______.___ <br />Rerna rks ...................... ......................... ............................................................ <br />............. ........................... ......................................... ................................. <br />.................... ..... .......................................................................................... <br />OrderPecei��ed ............................................................................................... <br />\Vork Campleted .............._...............................__....._................................. <br />Foreman <br />