Laserfiche WebLink
r - � <br /> s.,.►�.e.. . <br /> w.u. <br /> ' F E�EI�E --Water Dept. <br /> � � ' �� �� <br /> ApplicationNa...�.��� Date... .... ....:tC'{.:...................19..�. <br /> / �// <br /> AInstall.�.�"...�a1.._.... ._' ater ser�3ce pipe <br /> For ............ i..f/5,�... ./�,,,.- . L .1;�.......................�----......_.._. <br /> '... . �j� � <br /> On ............ .. ..1..3 a..P.. ft�..t{.t,��::.�Gr.f..✓'.......... ... Street <br /> � <br /> r.�t........................a-�.................---.......... s��k xo........���.3.............. <br /> Addition ................. . .. .. . <br /> Remarks ............. . •- ±-............-- <br /> -�...................._.._ . ..........._..................... <br /> ................................. .........:!.:f.1 r.u::�!�_..........................._......_... <br /> •: � . <br /> ,, ...........:.:.:....:...................................................................................----..._......_... <br /> , . <br /> __..... .. _..._. .......... .............................�.L .....�. .� .�. `.'1..�._.._... <br /> � � � � �� . !. �_....(..✓...<_/ Y. ..L.�4.�_ <br /> ........................... ........ ................... .� a�..:.... R ..... . ... <br /> � 3 ndmt � <br /> -���o <br /> 0. r-. 1 � <br /> LAQOE AND MATBR4V. IIBED ' <br /> No. Size � <br /> J. tt._. .......Y............ I.ead Connectlon Complete <br /> ..........'... ...................................� S�le Complete. i � <br /> ........... y t ................ <br /> ..........�.Gcr......._...... ; .. .c_.r.e.,t.1..:;,.,_.,..:....,_r.:t:1�F...............Pice <br /> ..................................................... Servke Cocic � <br /> ...................................................... Secvice Hoz <br /> No. Hours Labor............................................Cost.................................................... <br /> ' Cut in....................Pavement...................X........................ ........................59.Ft. <br /> ...................X........................ .� <br /> ......._............... <br /> ...................X........................ �� <br /> ........................ <br /> ....................X........................ .� <br /> ........................ <br /> Toal ........................Sq.Ft. <br /> Remarks. -� --./ '1 / — <br /> � � <br /> .......::.......................:� .................................................................... <br /> ........ .................................................................. ................................ <br /> ................................................................................................................... <br /> Order Recei��ed......................_......,... % r'� �'......._..... � <br /> _ .j......��:�--.....;--.�.._.............. . <br /> �Vor'.c Completed.......__..................:1....:;......`_:�7....�:..�.::.. ''�.:�.......... <br /> Fdfc�Qan <br />