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L'.L '111[�[ 'JM��y� ' � � �/ / �/ <br /> M. D. IO�M � <br /> CITY OF ERETT--�J�later Dept. <br /> Application No..---••�.`.�::.��='Date...........�:(:�::!..i.�:'..........19.:.� y <br /> /� Install.....1.. =f`.�.......inch ater service pipe <br /> . ! <br /> For ..........1.✓.-�:1..UIlzz:.:...._ ...:.YL.r.-.a�............................................ <br /> . , . . <br /> On .............�/..�..�......_�::.:.>.::.'...........--�--............................... Street <br /> " ^ _ .�L "�!c <br /> { <br /> Lot..---......_�..:_C.:.::.......�:....-•-.._...---- Block No.........-_-..._.....�......--- <br /> Addition .............�r:���. .x.......,:x..r..:�.+.P..i.:......./................ <br /> • ' f�. ,� ` , <br /> Aemar .k"-s `:'� ........, ./.�2:����:a`.�,-!��-_•�'_:�•::.........�................ <br /> / _. _ , <br /> _._/......:....G....::a�'... ..............._. !'��l�t��+��-�L�� <br /> Y � ....................................'_"""' <br /> ^....................." <br /> .._.......;->:...._�'tE.�r.`_�-��t1M�.._l�A...:�r^�%:..�_ts...... <br /> ..... ..--- ,�_ <br /> � � u tl-� � . <br /> .... . . -- <br /> . . ....... .............. . .. <br /> . ; <br /> ...�..... f� _ . <br /> Superintendent � <br /> C�I� <br /> LABOR AND MATERIAL II3ED <br /> No. Size � <br /> ..........................._........................i Lead Cunnection Completc <br /> ....................................... �.......... Saddte Complete <br /> ...._..../.�..St._........ . ..._.........._..L°:�/.:''�'' t- .................Pipe <br /> ��� ! %............_.. <br /> ...............t.......................... .. Scrvicr Cock <br /> .. <br /> ..............I.................C i/� Serv' Boz <br /> .....3�T H......... ............ <br /> � <br /> .............L.......... ,�� r�-t�.,......�1c.:...... -�!._'.....:..:��:1:�::.r...................--- <br /> / ...... ` <br /> ..............�(......................�(.......... ......�f':�:_��...!:�11.....�./...(..{.............................. <br /> No. FIours L3bor..............................................Cost.................................................... <br /> Cut in....................Pavement....................X......._......... <br /> ...... ........................Sq.Ft. <br /> •� � i � . � ..............._..X..........._........._ �� <br /> ', .. : r :. ........................ <br /> � . <br /> � � „ <br /> ...................x........................ ........................ <br /> -. _, . G ( ....................x........................ ........................ „ <br /> % _ : : . <br /> Total ..........._...........Sq.Ft. <br /> ----�- — <br /> --— <br /> Remarks._.f:::.�.�:�L�.......l..�:CI:....:I�.L:............................... <br /> .3 ,, c c_ , 3 l .�L'-ti,G-i ...................... <br /> __................. .....................:�............%.!��. <br /> .........................�....................... <br /> ............................................................................................•-•---..........................-- <br /> Order Peceived.......................................,.._.. . ........ 4..,.. .. <br /> ................... ...... <br /> ��ork Completed................ . • = I :;�. G r . <br /> ........................._....................................:........ . <br /> Foreman <br /> � <br />