|
N
<br /> � `vi PrF:.M1rm � ' IL
<br /> � CIT ���R�TT--�Uater Dept.
<br /> ! i� {� �VjJ4o
<br /> '�
<br /> ApplicationNo------ - ---- -- Date.-.- --- ._:."--'-- ---_Lg----
<br /> 3 %,
<br /> / f1lnstalL--;---.1_<- __-.inc6 wa[er se�vice pipe
<br /> For .---/-.��.%------ � � -- '---' - - --- v------ '--- '- -
<br /> ' --•'•-' - -... _
<br /> i .�� . , .. �- � , ,-_.
<br /> On ----- ----- -- -=--`-�..=`---�- -- --�--- �,.(-------------Strcet
<br /> Lot --- -�- � -.-,
<br /> � � _ 61ockNo(=-----u�!!� �-
<br /> Ad�lition -v- - �r -tC- -- - - -� -- "--•--� ' '
<br /> �1 - ------ -----. _ ..-- -
<br /> ..�L�/R��i�uTN:s/2-��J��---���� -------/- ----- � -----------._..
<br /> !
<br /> ----- �- ------�-•--- --- '::O ---•- - -- ----- - - --
<br /> .., , ,: , .,, . _ ';,i /% � - -
<br /> . ,�
<br /> . . ' _ _ '�"' .'. - -
<br /> : .,, � , , .: .. , • '" l'--'- i ..
<br /> . � "-'-.'- — .• ",'"�-- -° .. :"'=- ".-,':"": '-
<br /> -- .�• ' I . --,. --" "-"-
<br /> -' °• - � �� � r.,.,s< �
<br /> .. ,,. ...--' -� --- - ------•---- - ^ - -----
<br /> , �d, �,:' � S�.Qerimendem
<br /> ;� a
<br /> LABOR AND�MATER�AL USED ' t �
<br /> No. Sizc _— ._._.. ___. _ . ._ . _- _
<br /> ___--_—_ __- __.—_.__.___—_ _ .. . ._ _ . _._ .. —__ .__ _
<br /> "__"'_'"""' ___'_""'__ LcadCunnectionCnmplcte
<br /> --.'_- --'-3.__.. Saddle Complete � `
<br /> _'_'"""' "'
<br /> i� �
<br /> __"�L(f""'"14 ""'" """"_'�'.4 " '"_ �' �'"�" ____.Pi � ,
<br /> ��""'_' .� ��' "_' p.
<br /> _""'�"'""_... �� �� Scrvicc Cock �
<br /> " u"_"":'_
<br /> "'_"""__ '_ '_'...'_"""'"' Servi�c6ax p -� . /J �J _ . .
<br /> - --- ---.- �' %.----- .�_�_c—�fi-.-C,.��._ '� �rP:2-_/�fir-.--.-_F .,•-,�,_.
<br /> a---- tir � �%�-�--7-� - -- -
<br /> I--- �,-- v�Jz�z,��f�.�-h�:r-��-'--
<br /> -----�----- - ---3��-- -- �' - �} D A :s- - -
<br /> -- -..
<br /> �---'---'?��<�- ---- `'m,("�z�=`=--�r_.�i-aYar-:' '- -�'- - - -
<br /> - o !
<br /> --- - -- -- -
<br /> ---- ---- _
<br /> Na. liours Lnbor'_'___"'"'_""_9 Cost'G'��"'_
<br /> _""""""_"'_"
<br /> Cu[in__"""""Pavcmcnc.__"'__"_k_____._"" __'_"____""'Sq. Ft.
<br /> . ,� . ."".""__X _......____ .._.'...'___"_ ,.
<br /> � ~ty ----- - '--X ---- '------ --------- .�
<br /> ,� ,; . „
<br /> � $ --- -- --a --------- - --------- ----
<br /> . ,1 ,,
<br /> . � To��� �-----�--�--.s4. F�.
<br /> Rema,ks- --� -------- ------------�--. ... .--- ------- - � --
<br /> ---�- " ------------- - -� -------• --- �--
<br /> --------------------� . ,
<br /> OrderReceived- .--------- -- - .- ------ �
<br /> --
<br /> \VorkCumpictc�l-- - ----- - -- - -- -- - - - -
<br /> . . . - --- ----� - �'---
<br /> t�.,.,.,�.���
<br /> ��
<br />
|