Laserfiche WebLink
w. n. ronr+ T �� / � J � -� . '. -j i . , <br /> � -CITY OF EVLRE7T--Water Dep�:. <br /> r' -, <br /> Application No....�...:"<..L.J Date...........-F::.../.........................19._�t:-1 <br /> �I�stall...............................inch water service pipe <br /> ' ,J <br /> For .......�.�.,.�_n c i.::a:... �. ; c..a.�!............ <br /> ......�._..... <br /> _; �: � � � _ �...................................... <br /> O!i ......._.....:x...........:._.._..L-.c....=�y:::.....'`:�:.r.���......................... Street <br /> Lot.............................................................. Block No..................................... <br /> Additiun .... .. . .................. <br /> ............................................................................. <br /> Remarks ....................... <br /> .............._.................................................................. <br /> /� f - <br /> ...................................................<.:,�.✓_:�.i_(...:�,'..:::r::r.`` <br /> .................................. <br /> ........................................................................................................................... <br /> . .......................................................................................................................... . <br /> . .......................................................................................................................... <br /> Supr.rintendent <br /> LABOft AND MATERIAL USED ' <br /> --Nu. ' Size � <br /> ----- <br /> ...................................................... Lcad Connection Complete <br /> ...................................................... 51c'.dlc Complc:e <br /> .......................f t............................ ........................................................................Pipe <br /> ..................................................... Scrvice Cock <br /> ...................................................... Service Box <br /> ....................... <br /> No. Fiours I.�bor..............................................Cost.................................................... <br /> Cutin....................Pavement....................X....................... ........................Sq.Ft. <br /> ....................Y........................ �� <br /> ....................... <br /> ....................X........................ �� <br /> ................. ...... <br /> ....................7{....................... �� <br /> ........................ <br /> _ Total .................__...Sq.Fl. <br /> ---- — ------ <br /> P,e m a r k s..._....,,...,:.�>.............................-- <br /> ..................................... <br /> ;, . » .......... <br /> 1 ..ti <br /> „ - <br /> . ,. . , <br /> - .. r <br /> _ ................_..,.............. _................. <br /> .. , ............................................... <br /> �> . � .� ................ <br /> �' -'� .,�� <br /> ( , ' , <br /> .................... ...�.....�:-................x!............ <br /> ...................................................... <br /> Order Recfi;ed........................................... <br /> ................. ............................ <br /> \Vork Catnplcted..._......... ......................... .................................. ............. .. <br /> �oreman <br /> t�.v;'�' _''d.j:. <br /> �'A �9 ,� r �.:'. ��,. <br /> �r <br /> w�fi S§�' i.l",�� �. <br /> , '�'y � i � �4�. <br /> �'�� i.„��v. .. • v , bP <br />