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2224 PINE ST 2016-01-01 MF Import
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2224 PINE ST 2016-01-01 MF Import
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Last modified
2/24/2017 1:59:39 PM
Creation date
2/24/2017 1:59:30 PM
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Template:
Address Document
Street Name
PINE ST
Street Number
2224
Imported From Microfiche
Yes
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S.1 ^rI:S:1T +� `/, � ' <br /> W.�I).2orm J�� � � •' <br /> �,ITY F VERETT--Water Dept. <br /> EP. T �2� �// � � '�- �/ <br /> , ,�lication \o. ..................... Date............ .............,::.........-:-......191...� <br /> Install....�..�.�.`..._............inch water service pipe <br /> C Ol ........ .[.�..�i�.........�.�..................%r:sz�..............---._......---.........---............ . <br /> ....... ....... .............................. ....... <br /> in .2 .�..-................................ Street <br /> Lcl_..........��...�.�'z........................... Block No.......1................._.--- <br /> ���ldition .............._......,.��..............._...._.................................................. <br /> Pemarks .....................��f�J.L.G� ..en:::�....................------................... <br /> �....;...................�:.....- ....,............ <br /> .. ......................................................... <br /> ,,=��.r.`:�..zr.+� � . t l k._�.::.�..... <br /> ....................................................� ,� y-- •F-...------.. <br /> ............ ........................................ ..... � ,.....................----.........---.. <br /> _......._........._.. .......................... . ......l�� �2-e1�:-.�'.........-----.................. <br /> Superintendent <br /> �Y��' <br /> LABOR AND MATERIAL SGD <br /> No. i Sizc --.--. <br /> —� ---. .... .... �---- <br /> ..............._.,. ...._ i Lca<i Connection Complete <br /> ......«��.7..'....... ...... ...................'I S�dcilc Co lete <br /> ... '. � � .�',7� . .�.. ' ..............Pipe <br /> .._.. .. . ..._...._....._. ....���_......... <br /> ......................ft. . ................... Servicc Cock <br /> _...................................._.............. Scrvicc Box <br /> No. ilours L,bor..................................._.........Cost----............................................... <br /> Culin._.................Pnvemenf....................X_...._......_......... ..................._...59.Fl. <br /> _ „ <br /> ....................:t........................ ........................ <br /> .............._...Y. _.................... �� <br /> ........................ <br /> ....................X........................ �� <br /> ........................ <br /> Total ........................Sq.F[. <br /> _------ -- ---- <br /> i�^_.n��r.cs................ ............................................................................................ <br /> __.. ... ........ ..__...._....................................._..._............................................... <br /> ......................................................................................................... <br /> 'Jrdcr _�eccived.......,......................../...�.......,�--...........,, yy........................ <br /> \':o.•k Completed._.......::..:.'..�..........5..:�:::f:,:�:.-....i�.t..1.`.::�'�...l...��:.:...../ <br /> Forcman <br />
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