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_ ���/Z _ -, . - �-- 5:. ,.s, �� <br /> w. o. ro�r a - . � <br /> CITY OF EVEFZETT--Water Dept:. <br /> Application No.....1 G l/-�. Date......_:'....:_'............................19.�.`_ <br /> Install...............................inch water service pipe <br /> For ................................................................................................................... <br /> � � �' % ,�' <br /> On ....�:.4!.:%........t:c':.....:'.�..:::.'....z.�..................................... Street <br /> Lot............................................................. Block No.................................... <br /> Additiun ......................................................................................................... <br /> Remarks .................................. ............................................................�---....... <br /> ...............................................................................................�---.....................---• <br /> ......................................................................................................................... <br /> e f? � cv'. <br /> ................................................................................................._........-•---._... <br /> 7/ ,, ��� <br /> .....�.................�.................................. ...............................................-'--"---'- <br /> 4_��_ ��' Superintendent <br /> / <br /> LAAUR AND MATIiRIAL USED <br /> No. Size <br /> --- - -- <br /> ..................................................... Lcad Connection Complete <br /> ...................................................... Saddle Complr.te <br /> .......................it............................ ........................................................................Pipe <br /> ..................................................... Service Cock <br /> ...................................................... Servicc Box <br /> No. Hours Labor..............................................Cost.................................................... <br /> Cutin....................Favement....................X........................ ........................Sq.Ft. <br /> ....................X....................... �, <br /> ......._.............. <br /> ....................X........................ „ <br /> ........................ <br /> ....................X........................ „ <br /> ........................ <br /> Total .......................Sq.Fl. <br /> — --'- ---� <br /> P,e m a rks.......................................................................... .................................. <br /> ..................................................................................................................... <br /> OrderRecei�•ed............................................................................................... <br /> \Vork Completed...................................................... ............_.................... _ / <br /> Foreman <br />