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W. D. Farm.j�AO� 11.10.19 � • . <br />CIT �1' OF EVERE'I~I,.,Water Dept. <br />A��plication Na (1 � y5� Dacc_. _._ �i.�j <br />, 192...�.. <br />� I°�call . �/j� ��� ._ inch watcr service pipe <br />ror _.. _. _Q_,,�,� �. <br />�`'T� <br />OR _ ... <br />yb ._�. . .__. . ._.. ..._ Street <br />Lot. ._._.. Block No.. �/ ' �� �`• <br />Addmon_ � �, �,,,,�,� 1 � ��..( n!li , <br />, ,�� a 7 � l <br />�� � � e,� u� � <br />Rem trks .. <br />. . .. .. .°'.-vt�0-a.G <br />1 �' <br />• • <br />`r -_ o......._ _ t.,,>.-x.a,�- <br />____. <br />_.._.. _ <br />_ . ..... . .................. <br />_ _ __ _ .. ._. ......._..._.....__.._ . <br />___ _ _._...___ <br />__ _ ._... __... __. <br />_..__ ...._ _ ..__ <br />_ C'�.�- It� .... .._._. <br />..._ . <br />_ <br />s���«� a � .... _. <br />_---_' ",n�l <br />- _---- - � ., <br />_ _— -_-_-_ <br />LAI30R AND h1AiLR1�1L LSPD <br />- `_' <br />� � _ Na . i � Size � j . .. . ___ _ . . _ . . '. . . <br />— <br />- <br />_ __ <br />/ _ _ _ <br />�' �� '�-`� ��� Load Conneution Complete � <br />J <br />........_/.. ......... �.z.Y _� Szddle Complete <br />.. . ....... <br />�...__..fl.l _ _s_ ..._.._ _! ..':✓n,ft'........_._..........__.... <br />j : - ......Pipe <br />��������`�'"""'"�� � / - Servicc Cock <br />. ._..Y _ _....... <br />......_..__........_...i..ti'..:zc.C<:.. Servicc Bos <br />.........1 ��%y � '' � <br />..............i........._.z.._.. . C. .�(,�. <br />✓ r ..e..��.t:_......... <br />...........� ...............I 'Y A �< . . <br />, . ....................................................................... <br />.......... .... <br />� _ . .. ,._..... �.�-`��, t..� ....................................................... ._...... <br />.. ..... <br />_ _.. <br />.I _ <br />------ --- <br />_ ............ _ ..... <br />__. _ _ <br />� sy — -_ __-_. <br />No. Hours I.abor........._�- ------�-- <br />.......... _.._...........Cost.._...- ........................................ <br />Cut in ..............-......._Pavement.....................1'...................... ._.._ . <br />......._...........Sq. Ft. <br />.................... X.................. <br />...... .................... �� <br />....................X....._.................. :� <br />.............. _.... <br />....................X....._....._....... �, <br />.. ................_.. <br />- -- _ _ . Totul ... Sq. I� t. <br />_— <br />- -._ .. _ ......... <br />- - <br />- -- <br />(. . . ,__. _�- --=-' <br />Rem�rks 1lrtrr�al 51ip_?�� �� /� <br />, . / <br />i_.,tc �C ./ "p ,� _ _._ <br />.._ .r .a-th.:s1.�.. zqt,�.mv/ _ -c� /t e-r r, � c . <br />0 �.. <br />_ _ <br />Ord�r Reecived • <br />\��ork Compleced _ %% �/ _ _. ,. _ <br />� <br />L.�i F v -ea� <br />�/ F�« .� <. <br />