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S.>.PrieM�X7-16�6 �p 7 _v �� v�(�',1,�,�L� s <br /> w.u.va.m� <br /> CITY OF �E�IERETT--Water � ep <br /> Application No..�lO..�D.�--- D te.......................�.�.. ....�1.�.....1�/- <br /> /� Install..........�(�--1..........inch wa er service pipe <br /> � For ............�X/�.�u�n... ............ .� . `�..-.....----...........---------.. <br /> On ...............1..9�:./...... ... ....----........................ ....................... Street <br /> Lot.............................................................. Block No..........................---......._ <br /> Addition ................. ..............................7�....�...-.....—.......................... ........... <br /> Remarks ......... ... ................... ... .�E�bL.t(4�.-...... /.��/.4�4(:-/ <br /> ��... ...................�--._.�........_..._ <br /> _ <br /> ......................� .................. <br /> ��e. .r.LG.0 '—F-' <br /> ....................... ... . ....... <br /> � •� - -- --. . <br /> ................................................................................................�-- � <br /> �....�.J...��., <br /> ......................................... .................................................._. <br /> — — Superin deat <br /> . � <br /> L9B0& AND MATERIAL IISED <br /> No. Size i <br /> . ................... ............._........_..I Lcad Connection Comptete <br /> ......................................................I Sa3dle ComPlete <br /> .......................ft..........................._' ........................................................................PiPe <br /> ._..........._...................................... Service Cock <br /> ...................................................... cervicc Box <br /> No. Hours Labor..............................................Cost.................................................... <br /> Cutin....................Pavem=nt....................X.....----..._.......... ........................Sq.Ft. <br /> ....................X..............._....... .� <br /> ........................ <br /> ....................�........................ „ <br /> ........................ <br /> ....................X........................ �� <br /> ........................ <br /> Total ........................Sq.Ft. <br /> ----�-- �� �- —_----- — <br /> --- � <br /> - <br /> Remarks. �....: ..' � . ..,._.._ <br /> . ..................................................................... <br /> ti.........�. .. . ..�..�. <br /> .....__....................._.__...................._..................................................----.......-- <br /> ...................................................................................................................... <br /> Order ?{eceived.__.........._........................................ ..�.�,%�:r, .._........:_-'` / <br /> \'�'ork Completed.-,�.�.:'�.�_".t...�.......:...-�_.<_.�.�:.(:�`!.'f l. � <br /> � Foreman ` <br /> , • <br /> � <br />