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a <br /> s. �. vni�n� ��V (..� � , ' . . <br /> w. o. rowrn :�� <br /> Cl i Y OF LVERETT--Water Dept. <br /> - nr.c t�e; <br /> Application No....::...:i. ��..:;.�.1 Dale_...__.._............................_-._.19...... <br /> ,;;�� Insiall...............................inch water service pipe <br /> i <br /> _ <br /> . .: , <br /> F�t .....r._�:......_�...._...._.._..;.....�.._.......z.t..............................:........._............... <br /> . � ,� �- : . . . ; <br /> ��....:_l�...4.'.(_.L...!:..�..:{."[ C..:�,---_..... Street <br /> Q11 .......................�........... . .�......... <br /> I.ot............................................................. Block'�No..................................... <br /> Adiliti<;n .......................................................................................................... <br /> r;emarks .......................................................................................................... <br /> ................................................................................. ............................. <br /> .................................................................................... ...................... <br /> _..........................................._....,......................................_.... <br /> �������� � � i Su�crintendent <br /> LABOR ASrD TIATERIAL USED <br /> No. ' Sixe i _ <br /> _—__ ._-- __—__— <br /> . ....._.......................................... Lead Comiection ComPlete r '. . - J <br /> ._................._�ft............._............J Snddlc Completc.. .........�..���.�._�.....�`...._�Pip�� _ <br /> ...................... <br /> ............................ <br /> ..._.....___._....... Scrvicc Cock <br /> ...................... <br /> ...........__................. Scrvi-c Box <br /> No. Hours Lsbar.._.................___ ........_.......Cost.................................................... <br /> Cutin.._... _....__..Pavemc:it................. ..X..................._... ......_......._......S9.Ft. <br /> ........._.........%........................ .� <br /> ........................ <br /> ..__..............X........................ .� <br /> ....................... <br /> ....................X........................ �. <br /> ........................ <br /> Total . .............._...Fry.Ft. <br /> _---_ --- . _ . . <br /> Remarks _ . - .. .. - , , — 1 <br /> ���r �'/�',�� > -_ —t�'� ..���( ��i—�1-�y�R-.i�.. <br /> � � � . <br /> .. ..... �� .. .: . �� [) � V j.1�i,i�� ,/i/ '/f°<. I _ <br /> . .. �.� .'� �!/f�il � . . �� ���_.. �. <br /> OrderH.ecciced._.............................................__..................__._..._............. � . . . <br /> , , <br /> \Vorl: Gompleted......_..... _......_ ... _. . ... .._. ..__._ . <br /> Fo;eman <br />