Laserfiche WebLink
S 1.Priehe�M7.162�5/ /O Z ' . — , �- � � �) <br />V!. D. Form Y <br />CITY OF El�ERETT--Watex Dept. �/ <br />///o?� �`-� "�r ,�' �l`' < <br />Application No ........................ Dat��/ ....:..........................................19......� <br />i/ Install.......= j�.!�".,�.1....inch }�j� service pipe <br />For ........ <br />On.......... <br />Lot.......� <br />Addition <br />Remarks <br />:.::..."_�.._ :...::................� . 'Street <br />. BIxk�No.....I. r�.�.. .4.. � . '� <br />. � _., -,:�,. �� .l„ <br />. � <br />_��.7...r._.;..:d ..Y...........!Cl..�...i..:r..:_c..s..... .................................._...........---... <br />��N' /.t-/�-�7 (: (j <br />! ..: <br />i.ABOR AND MATERIAL DSED <br />�.� �.�..�..�....���� ?,� �, !_� ` <br />� ..,. <br />Lcad Connection Completc <br />Saddle Complete <br />...............................:.................... <br />Service Cock <br />Servicc Box <br />........... ....� .. . <br />. . -•_ �....�..y.....� <br />No. Aours Labor ............................. <br />Cut in ....................Pavement.......... <br />...X ........................ ........................59. Ft. <br />...X ........................ �, <br />........................ <br />...X ........................ " <br />........................ <br />...X ........................ ,� <br />....... . <br />Total ........................Sq. Fl. <br />--- � � •�•, � <br />.. ,. <br />Remarks..�,�:�.........CL.. ." �"'�.... ........................_...... <br />......... . ....:.:.: � :-.:....................._ <br />( ' <br />.............................................................................................................................. , <br />� <br />.............................................................................................................................. / <br />OrderReceived ..................)..........:..................:..y: y:,y....:.............:........ <br />p ,�� .,Fl�"�:..• �. . , - r.-,�;�t'. - <br />\�: ork Com leted ....i.L.:' ... ......:i..;.........'�..i:....::....Lr .....:........................ <br />' Foreman <br />