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N. D.�Form ) IOJO II.I0.E7 � <br />� CITY OF EV E�tETT-•-Water Dept. <br />Applicatiofi No.p �`Tv ate..... _.... _..... � i 192.."'.. <br />A <br />� _}_.. Install . � 'nch w er service pip <br />For . . _ � �-e�,1-K.� . �I1 r �`i� . Q'�-R.� <br />On .... �..."t a'�- �.... V.� i.,n._t_,.� ._.... Stteet <br />Loc. .... � � . ... . Bl«k No._ 5 �-`'. _ <br />Addirion.............._..... ........._....... __..........__.._............. ......__........__.._ .__ .._...... <br />Remarks..._.........._._ .................................................. ...... _.__...__......._...................... <br />_... _ . _..........._...__............_._........- ._..._ ................._.__......__ <br />_...... _......_. .._. __ . ............_..... .............._.._............. ......_.._.. _ <br />__ ...._ __ ........ <br />_�. �.. ��-d--� � . <br />i <br />—_ — _ =___— __— -- � — _ <br />LABOR AND 111A7'ERIAL USED <br />...,. . <br />.......! ..... . ..'.�y. '-... � <br />.......l ..................I._3!e'.X. � ........ <br />..._.�..!1......._fS. .. �!!. ��... ....... <br />. <br />........L ................ �:....Cl.`........_. .. <br />...../ ............... �.�.�,....... <br />......1 .................. �i.� .. <br />......f . I ..3/� K`'. <br />No. Houre I.abor.. <br />Cut in ................—.... <br />- ---- - - - -- - <br />Lesd ConnecGa� Complete <br />Saddl$� Complete <br />� �.�il.� ............................_....._.IHpe <br />Service Cock <br />Service Aox <br />QL,s.�r,4 ... ............................................................................................... <br />� <br />n, .. ........... ..... .. ...... . _ <br />_ � _ ...... ........ ... .._. .... .. <br />......... .. __ _ <br />—'---- ----------.. <br />f--3G <br />.._/..r� ......................(.mt.f.�'...- .... ................_............ _ _... . <br />.Pavement..........._.......:C ....................._. ....................Sq. Ft. <br />....................X................_...... �� <br />......._...__.... <br />� ,, <br />.................... ....................�. ........... �. <br />....................X ...........___...... ..........._...._. .� <br />Totul ...................Sq. Ft. <br />� --_--- ._ --�-- <br />— - — <br />—_--- ----_ <br />Remarks !risteti�l Shp No�_ 7 � .. . ...._r <br />o_.... .. . .. <br />__._.4�+^� 1-.vr�-n.o�..�.,c..Ycv✓�E»Lix%� . <br />� _. <br />._....._..... <br />.__..._... _. __... .._ . ... .... ... <br />. . ..... . ..__. <br />_ _.,.: ���& <br />. . _. . . ....._. <br />Order Received �y� <br />Work Completed Qf ' <br />�-e.�.� . e' .. <br />