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„`rA.. <br /> £!. <br /> k{ <br /> ti s- <br /> �r�: <br /> . ,� <br /> + ///O C � :. i <br /> w. o. ronr+ � �/� � <br /> � ' - �CITY rJF EVEIZ�TT--\�later Dept. <br /> ���, r� �� <br /> �� • , <br /> �,.� A lica[ion No . 'J /.r� .�Data...... _�:��........ .................19..�� <br /> E Jr , PP � �... . . ., <br /> k���5 4 , ................ / <br /> Install /.. ...inch water service pipe <br /> � � ' �/ ........... ...... <br /> .. f � ; Y T,�' ..hr }.�................ . <br /> � f ,. For . •..�'2:2.t.:z'. .... �-y' � <br /> ,�: J / . <br /> � l ���`�.T�.J.........---- Stnet <br /> �� ti r <br /> On ..... -�%,?..�`..��r._.....�` �%£s/......... .. ..r . ' <br /> �F «�,',�;;, . . Lot.. ............................. ..... .......�� -.. Block No.......................------••-- <br /> i+ ' 4�.1-r .. ' <br /> Addition ........ ............... .. .............. ......................... .. .......................... <br /> Remarks .............................�..........C�---'�i z/................................. : <br /> .............................:.................. <br /> C..sL�J.kzk.. �GL..:...4...1...................................._' <br /> � ...........�................... ...................................................................................'-' <br /> ..............._"--"'.... <br /> ...............................................................................................Superintendent <br /> LABOR AND MATERIAL USF.D <br /> �. . N°_—�---i---- <br /> _.. <br /> ue , ,cad Connection Com�+letc <br /> � ..........................I. . , <br /> ...................................................... <br /> � Saddle Coraplete <br /> .......................fi'.I........................... ........................................................................Pipe <br /> i • <br /> _......_.__............ Scrv�ce Coc4 <br /> I �..�......._........... ..._.........._... Ser�ice Box............_�......._......__............_�............_........._......�..._.._.. <br /> ....... ....I <br /> ...................................................... ...................................................... <br /> I ........................................................---.................. <br /> , . . . No. Hours Lsbor..............................................Cost......................................._........... <br /> .�,�.r,.d; <br /> ....;-� Cut in......._.........Pavement......... ........X.. ............. ... ......... .....Sq.Ft. <br /> -.,:_..:.... <br /> �� <br /> ....................X........................ ........................ <br /> ....................X....................... ........................ <br /> ,. <br /> X........................ ........................ �� <br /> ..._........._-�'Total <br /> ........................Sy.Ft. <br /> --- <br /> Rein arks.................................... <br /> ........................................................................ <br /> Order.Received............................................................'..........................� <br /> \Vork Completed................................. <br /> ..................................................... . <br /> Foreman <br />