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i <br /> _ � � - _-.�. <br /> a d. rmaeo_aH � YI � � ' <br /> w. o. rona a <br /> CITY OF .EVFREIT--Water rept. <br /> Application No....:J'.4•�.�'� Date.._�... ......7.. ............19:e �' <br /> � � . <br /> Ir.slall......—�/f............inch water service pipe <br /> ��...�":..........L...��l::t:��:•'.�.`" <br /> or ......................... <br /> ................................... <br /> . . . .............. ...................... Street <br /> On .......................................................... <br /> ..... . <br /> Lot...............................�.......................... Block No......1.:.�................... <br /> Addition ...................... ,-............................................. <br /> . ......................... <br /> � <br /> Remarks -- '�r.<._--.--��„_,_,,,,,,_. <br /> � .......................................................... ................................. <br /> ............................................................................................................................ <br /> ......................................................................................................•-----............ <br /> ..................... �..............._................... <br /> ......................................... ...... ... ......:..... <br /> .......�--�--����C'-`'x:�.. : . ................. <br /> ................................................ ` � tmtendent <br /> ./ <br /> — -� <br /> LABOR AND MATERIAL U86D <br /> Nc. Size <br /> -- <br /> ............................ <br /> .......................... :.cad Connection Complete <br /> ..............................._....;............... Snddle Complele <br /> -.......it............................ ........................................................................Pipe <br /> ................ <br /> ....................:................................ Service Cock <br /> .......................... Service Box . <br /> ........................... . <br /> No. Hours Labor..............................................Cost.................................................... <br /> Cu+ in....................Pavement....................X........................ ........................Sq.Ft. <br /> ....................X....................... ......._............... <br /> �� <br /> ....................X.................... ... ........................ <br /> �, <br /> ......._-'�---.....X........................ ........................ .� <br /> ToL 1 ........................SQ.Ft. <br /> _— �--------- �— � <br /> Remarks............................(.....i:.�..:.....r..:..:...�............................................... <br /> �._:..:............:..:..::....._i.:......:............................... <br /> _..................... <br /> �..:.:.l......::..:.........:......._..................._......... ......... <br /> .............................................. <br /> Order Receive�i............................................................................ ........ ........ <br /> , <br /> Norlc Com leted.:..:...............:..:.:.' `^ �. � , , .. . <br /> p ............_ .....................:.................. ....._. <br /> Fme an <br />