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��a90 ,; <br />, ,� �; ��.- �- <br />�+. : rovw r _ — <br />CITY OF FVEKETT--Water Dept. <br />, � . �� <br />�, � :� �. �/ /,l' � � � : ��° <br />�pplic. tion No .................�.... Date................................................19...... <br />; � nstall_.. ........./ ......._.....inch weter service pipe <br />- <br />. —;-�-�---.� c:,�:: �1'�.:..�,�..t �. <br />��� . '� ,.._..... �.. _.._... L:. . � <br />/ }.... _ .. ��.. �.�.� ................................................ Street <br />On .....:......... /../..cn.:-. � <br />I,ot .............................................................. Block No..................................... <br />Ad�.lition ........_........._ ..........................__............................_......................... <br />Remarks ............................. <br />............................................................................ <br />..................... ................................ <br />.................................... Superintendent <br />No. <br />Sixc <br />LAROF. AND MATERIAL USED <br />Lc��d Connection Complete <br />Saddlc Complete <br />................................................... <br />Scrvicc Cock <br />Scr�.icc Eox <br />................................................... <br />.................................................. <br />................................................... <br />..... _ ............. _............................. <br />No. Hours Labor.......... <br />Cut in..._.. _.........� vc <br />..X ........................ ........................Sq. Ft. <br />..X ........................ ,� <br />........................ <br />..1i ........................ ,� <br />.................... .... <br />....................X..... .................. ........................ �� <br />Total ........................59. Ft. <br />__--'z-_ <br />, , . ..... .. <br />R e� nar„s ................................................................................................... . <br />.................................................... ............................................................. . <br />OrderRecei� ed ............................................. ........................................ <br />1�'orU Cumpleted_...._.....__..__._._.... _.._ _.._.. .._ ............... <br />Foreman <br />� <br />