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9991 ' � � <br /> w. o. ronM a <br /> CITY Q����RETT"Water ept. <br /> , ��- <br /> - � -. ..��:.. <br /> . .... <br /> Application N��-.. . . .. Date....�..""............^.. .. ..... . <br /> Install......J�.���-�r����•���inch water service pipe <br /> . .. <br /> For .........................�..7.......................�..... <br /> .................................... .. <br /> � (/..�..J........�r....'"':'!�Y.......................... Street <br /> On .......................... ... . . <br /> Lot.............................�iG.'........................... Block No............_...�.�...-............... <br /> Addition ........_��..........................:..(,.._..�.. "'��" <br /> ! ii <br /> ........ <br /> �l4�!:.G:.... .. i` -�C�s•;,�,:[_.�.......�` <br /> . <br /> emar]cs ..... .......... .... <br /> � ....... J : <br /> ......... ... <br /> � l. . �4.:�fI....�...�P.........".'....:_it..!._`�....................................... <br /> ...... <br /> . . .........��........................................ <br /> . ..................................................... <br /> '"� `- . <br /> . . - <br /> ............. ........................ <br /> .... .. <br /> .................................................................... �� ..!/S., <br /> ... ......-- <br /> Superint ent <br /> ........ i �- <br /> LABOR AND MATERIAb-Hac� <br /> No. j�-- <br /> --- <br /> Size <br /> .....I :.e.d Connection Complete <br /> ...................................._........... Sodt�le Complcic <br /> ................................'_:......._....... / PiPe <br /> ...i �l......._._.. ....1...��`[:LL.�.............................................. <br /> ...... <br /> .r.3.....tt.. ./• <br /> .....3/U............. Ser e oc . <br /> ....................�....... . <br /> ._,,..... Servue Box <br /> .._...�........__....-......_............�........I �...._....._...........�_........._..�........._......_...........�._.........._..._._................ <br /> _................. <br /> ...... <br /> .......................... <br /> .... os .................................................. <br /> No. Hours La or............... X........................ ........................S9.Ft. <br /> Cut in.........._.......Pavement..._...__......... � <br /> .................X........................ ........................ <br /> . <br /> .. �, <br /> /�, c��.�. ., ....................... <br /> t . ..... .......X..................... <br /> , .................... .. <br /> ....._.X. ................. <br /> Total ........................59.Ft. <br /> _� <br /> �--------'__T , <br /> R e�n a rks......................... <br /> F.:.::: c.J.. .,:.:��.s:�..,.........._..... .............................. <br /> . / „ .._ ..�................................� <br /> �.. ��<..�,.....c..c..�_ _....._._..... <br /> .. ........ .......__.._........... <br /> ....Z.'.:.n:'.:t.-�.:.......................................................... <br /> ............................................... <br /> . <br /> . . . - <br /> OrderRecci��eil................:................................ ....... ........................... <br /> � ...:......_.........<�CI�L.:._c-`Foreman... <br /> \Vork Completed_�'..�����j��•� ' <br />