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a�'ueot��t.t�.aea�e+�3 / l <br />CITY OF EVERF,TT--Water Dep�. <br />, , _ <br />Application No....'i:'._�.�_�_..... Dat� ......................._.L:..t...:'i::......19�!..p <br />,( Inst�ll.......:.;: : ! `-� ... -.:inch water service pipe <br />} ........ <br />For........-../a.!�......G!...�_:....._i�-<._> .:...:......:._.'._ _.......,::................... <br />�..�....�._..]� ...........:.:..:...:...................:.�.:.........L..:.r:.:, Street <br />On .........- -- ..... <br />,- � <br />Lot.......... .--- �..�..'...�..�% ................_... Block No................../...............--- <br />AJdition ...... ...: - ............................�.._....... ............................................ <br />.. <br />j✓: ".::,.'.:._.'....__ .....:......:......�.... <br />� <br />Remarks :� ............___..... <br />........ .. .....:......... ..... � <br />,- , <br />, � <br />--f� � ...--. c......:.__..__......_......... .._ .................-- <br />.i_._ _.._ ..:............. <br />.__..................... ...__... ... <br />. . �, . �.. ...... ............ �,�� , ;_�`..... <br />. . .. � <br />,, �' �l f �, .-' ..... . �---: _ <br />� , �� ��� Supermtendent <br />__ . � <br />�i•y f n � i <br />�t¢r <br />/ ` � LABOR AND MIA�.T.L.1:I9L I�Se:D <br />No. ."I`� Size <br />........................... ....... ...... <br />....................... f t. .......................... <br />.................. _....... .......................... <br />icad Conneclinn C:�Icplcle <br />Sadd:e Camplete <br />....._........ _ ....... ..........- -. ..... <br />. . .... .................Pipe <br />Service C��:k <br />$L•1'VICC BGR <br />... _......_ ........... .........................._.. ._..........._...... <br />........._ .................................__............. _... _............ <br />t tlo. Hours L.:bor ........................ <br />Cut in__._._...._._Pavement..... <br />a <br />........................Sq. Ft. <br />........................ „ <br />........................ .� <br />� ........................ . ...................... <br />....................Total — <br />' ..._....._ .............Sq. Ft. <br />_ -- --- <br />................... <br />Remsr s- .............................................................._......._............... <br />_.._.......__ ........................... -- <br />OrderP.eceived .............._......................................................_....................... <br />\Cork Completed...._ ......................_................................_......_..Foreman.. <br />' <br />