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. � ��.. 43 7 ��,� �. <br /> [��M�•{ <br /> M'• 0. IORI{ � <br /> CITY OF i�'IERETT..Water Dept. <br /> /��`.'� ,; i � a ;l� <br /> Application No.................•- --. Date...._'-...�... ....... ..19.�.. <br /> -- <br /> ............. . . . .. <br /> *nstall.......�.�� .inch water service pipe <br /> ..........�.. <br /> � �) � , l.� • <br /> For ........................... ..-� '...1:.::_:.....1.�..:';...'...:....:.:. + i <br /> . ...... <br /> ...._:....................... <br /> �/,1 .. ��r:,: _ . . � <br /> on ---...-- ....... .............-., - screet <br /> .. ... . <br /> _..__............................•---..... <br /> Lot..................� �..........._........._... Blor.}c N�._......_....... <br /> . .... <br /> � ................_.. <br /> Addition .........�..;:..t.��.t.a.,.:.......:..� s`r`'� <br /> --•-- .......:�...................................... <br /> .tcmarks � <br /> r . <br /> ....................r�,.............--��---..............._......_...---- ' <br /> � .......................... <br /> � ^ : , ._, , � . <br /> .........................................:............_..:......:......:c�...:......:....:.:_:.....: <br /> ....... .. .......................... A <br /> . ............................................"".....�.......�.....:..........."' <br /> ..... /.... . . ......���.ii � ./ . � <br /> ('. . ..�...... .�/ .'. � C.� .. .• <br /> ................��""...:... <br /> ;r� � � 7,��. �1� -r--:-�---.....:.:._?�- <br /> ��Super�ntende� <br /> _��s� � <br /> � .' 4 LASOR AND MATERW, DSED <br /> No._ . ize � <br /> ..................................................... Lead Connection Complete <br /> ......_..........................................._. Sudd]eComp:cte <br /> .........._._w.�ntt_..''J.4................. ....�.Q< .:�l?........................... . _.........Pipe <br /> �� ........ <br /> ......................�. <br /> ....._'.;.�:.:.............. Ser icL�Cock <br /> � <br /> ..................................................... Servicc Ber <br /> ...... ................................................................................................................ <br /> .......................... ........................... ..........................................._....._......... <br /> No. Hours Labor............................................ .Cost..._......................_. <br /> ...................... <br /> Cut in....................Pavement....................X......._............... ........................Sq.Ft. <br /> � �a �LL1en/....................X.................. a <br /> .y! � ...... ........................ �� <br /> ' ...................X........................ <br /> ........................ <br /> ....................X....................... :. <br /> ........................ <br /> Total ........................Sq.Ft. <br /> -------------- <br /> � �__ <br /> Remarks.............................�.�.. .�.ua.....ir.c�u.t:............. <br /> ............................... <br /> , > <br /> �,.............................................._�....c...... .........+a�:. <br /> p .......................................... <br /> ...............................................�...m.m�,w t...�..�f <br /> ...4............................"".............. <br /> OrderPeceived.................................................................. .... ................. <br /> � y.. . . <br /> \4ork Campleted....S.-:/..2...' '?.y ...L�C/.Ln-ca2...... ../ <br /> .. ....................._. . <br /> Foreman <br />