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7'r�8 <br />5. 1. iriebe�7- 29555 , <br />W. D. F L. 1 <br />QCT Y O GQVERETT--Water Dept. <br />��/ t <br />Application No .... T 7_Q..... Da ........_L�} ...............19Z .! <br />Install. ....... .7.'- 1........... in6. �.water service pipe <br />For <br />On <br />LABOR AND MATERIAL USED <br />No. <br />............ ........__,,.,,........_. Lead Connection Complete <br />..............._..................................... Saddle Complete <br />...........�.�._..St. _. � Y......t.G...: _� �::v.................................Pipe <br />...................................................... Service Cock <br />Service Box <br />Street <br />1o. Hours Labor ................................ .._......... t;osr........... _....... ..... _....... ................ <br />Cutin .................... Pavement .... .............. X ........................ ........................ Sq. Ft. <br />....................X .. <br />.................... X........................ ........................ .. <br />Total ........................Sq. Ft. <br />---------------------- <br />Order Received ................................................ ..... <br />Work Co:npletcd..8, ..S '...yz......- .. ............ <br />Foreman <br />