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W. D. F111 6 1500 3-1-17 C. P. <br />` -C1TV OF EtVEtZET+==NVater Dept. <br />Application No. Date____ ___.--_-____1911_- <br />- — Install____�_� ---- inch water service pipe <br />For ------Cry <br />On �y ------- -------- Street <br />Lot _ Block No. - ..$ % <br />Addition----------- ------------------ ---------- <br />Remarks. ---- -------------------- ---- <br />----------------- ---- ------------------- ------ <br />P �perinterdent <br />r LABOR AND MATERIAL. USED <br />=o._ j1ZE <br />_.. Lead Connection Complete <br />Sa <br />,. <br />Pletc V <br />Service Cock <br />�.._._..F-_____. ._ �. ••.. _. Service Eux ------ <br />-_-._.-___-_.____________________________ __._-__--__-.-__-._. <br />� <br />No. Houro Lxbor.___6.____.______Cost. _ __t..3-. --------------- <br />Cutsin ------------ _.. Pavement ---------- X._------------ --- ------ ._Sq. Ft. <br />----------- _ �• <br />. _.___..___.• <br />_h__..__. --- <br />._ Total. ------ Sq. Ft. <br />Remarks- - —--- -— - - —- -----------—----------- <br />---------- ---- ------ ---- ------------------------ <br />------------ -- ------------- <br />Order Received ------- <br />Work <br />Completed ------ S !----------- <br />Peremalt/ <br />