Laserfiche WebLink
s l.n:.w�t+r x � � `'� '�. ' <br />V7. D. Form ) + " � <br />Y VERETT--Water Dept. <br />,� „� ;' ,� � <br />e� !f •�� Date......��....:.._- �;' r- �'% <br />Application No ........:...... ....... _......:...---.....19`..=-- <br />_ , <br />_, InstalL...-_..��1...�...........inch water service pipe <br />./ (� ( / ; <br />For......�cC...:..C_...)...........:.._%.'..:._--'.::.:..��_.._ .................._-----.............. <br />On .....---...........,r:.:�'...L...�........._f::fi�' — , � <br />. , <br />� , :� __. <br />.........::..._ �.:..:..t....----- Street <br />Lot...........1?.....�..%.!�' :.................... Block No....----.......---------..... <br />Addition +"_ � . ..................... �: .- -....................----............... <br />Rcmarks ..._� --..�......�:�:i.«..`..*.'.__�. <br />'�`�::;•�- - --- .................... <br />.........__._ ....................- -.................... -....................... .... -.............- •--• <br />�- ......,...�;....y.� ..........................................................---•--•�•----�--- <br />I . -" , <br />_ ..r ..........:..............................................._......._................----.................. <br />: __........ ., .� <br />- <br />� /�._._._....__ � .' � � � ri C-. <br />•� ._. -. ' i i � . '�........._....__......."-.... <br />.............._._---......................................... /. <br />� ,r........_=�.�. <br />' Superintendent <br />I ----_ <br />LABOR A:VD MATERIAL USED <br />No. � Size <br />Lead Cnnncrtion Cumplete <br />Saddlc Complete <br />.............. _ _.... _. <br />Scrvice Cock <br />Scrvice Box <br />......._ _ .............. <br />.............. _ .......................PiPe <br />DiaHours LaUor ...................................__.......Cost......................._............................ <br />Cutin ................... Pavement...................X....................... ........................Sq. Ft. <br />................... 7C........................ .� <br />........................ <br />....................R........................ �� <br />.................-..... <br />....................X..........._.......... �� <br />........................ <br />Tntal ........................Sq. Ft. <br />_..___—:—� ._. __� . — _ <br />Rernarks...:K......__ ......:..........._t...._ ......_..........._.........................:. <br />�-. <br />__.....__ .......................................... _..................................................... <br />_ _........ _ .................................................... _......................................................... .. <br />CrderReceived .......... .........._....._... _.....,......._....:.........:.....,w........�......... � <br />... . � - ...,! y .�'-, .,.� r: .i � ,-' /� i <br />'drork Completed.....�:....:.:.^...:.... , � ......_f1.:._-:.�:....�.:.::r.:.......� <br />.... � ................ <br />Foreman <br />