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5. J. PawLa4M �.iti 39� �, �� <br />W. U. Eorm J �/ . • <br />CITY' OF ERETT--Water Dept. <br />Application No....� �.�.���._c/ Date......� ...........:........:.........r.........19�..._` � <br />___� Install ......:..:.:.:.................inch water service pipe <br />: . <br />For.--..�:....:�._t..::a__ .:.......:..........:....:.....:..............�..:.1.:_:-.:.'.--.............--.. <br />On - .....�::.2... i.....: �........._:._.._.:....:.---_....:::: .� _. ............ Street <br />Lot................ ......................................... Block No........................--�---��--�-- <br />Addition.. ....._ ......:....................._......._.. .........._- --� -- — -` - - <br />� ..� <br />i . <br />!' ';i-. <br />; � '' <br />�� R ' q.s !._.... <br />� <br />_ - �.1�:...>. _ _, <br />......... .......... <br />, . • r <br />LABOR AND MATERIAL U3ED;�' <br />Lcad Connection Complele <br />Saddle Complete <br />.................................................... <br />Service Cock <br />S�rvice Box <br />No. I3ours LaUor ..............................................Cost.................................................... <br />Cutin..._ ...............r avement....................X........................ ........................Sq. Ft. <br />....................X........................ �� <br />........................ <br />....................X........................ ,� <br />........................ <br />....................X........................ �, <br />. ....................... <br />Tolal ..........._...........Sq. Ft. <br />Remarks.r„�..� �..�...�'7!j'�..._::.:r_tl,..�i ........................................................ <br />�� <br />__ -- ........................._.................._.................. -._........................................ <br />_..._.._ ....................................................--........._.........._....... _....................... <br />OrderRecei�ed.__ .......................................................... � . �_. <br />-� . r... :...: ._....... .. <br />. <br />� - � �i.,• .;� �. l,i �.si� <br />�1ork Comrleted.!�.....-..i::...r...,.._ .............._..._......:::^...�..i•�.J:..:.._.:.......G. � <br />' Foreman <br />