Laserfiche WebLink
, ���..���18 ' , � <br />, <br />� <br />. i'! _ . <br />T--Water Dept. <br />, . ,- � <br />, , ,. <br />Application No �.�'..�..�....� Date.....:.:...._-.L..�/_ .....................19�..- <br />, i Install..::.:�w�._��............inch v�ater:.ervice pip�� <br />For � ;.: _; /�4, „ . ". <br />_ ...................... _.:...:. _ -.......... f.........................: ...... ................ _ _. ......... <br />,— - i <br />On . / ; . . ...:........1`:.::i..:..:............:::.-r......................_ S.rcet <br />Lot ........... ..........__._ _. . <br />.......................... <br />....._ ..... ............... Block No...._�.................. ..... <br />. • . , � . / <br />Addition �,...t :::.........:. � . <br />.................... .._.. ................:..l........................... <br />P.emarks .................... ........... .......................................................... <br />................................................................................................................... .... <br />�., , .• �_:_ �.� r' �.�. <br />� _ .................::.......:......................._ _..................................................................... <br />•, � � <br />�.. � ......�...:.t.._L.......... .� ............................................................. . ..�.................. <br />� :._... <br />rV i\'. . , 1- r <br />� i ♦ i <br />� r <br />� � �� �..in�.... ........ ........._f.l.... ... / .. � , /. <br />.._. _..., .., �,......__ . ....................... ..---..........:... <br />, � . .._,. c�,...,.:..e.�..a�..s � <br />_ �" <br />_ ;�r <br />i. � Si: <br />' � <br />........ f t. .......... �:...: <br />7r <br />LABOR AND MATERIAL USED <br />Lcau Oonnection Complele <br />3add�c Co�npletc <br />Sen�icc Cock <br />Ser�ice Hox <br />....... __ ............. <br />_.. . ........_. ..._ ._.. <br />...... ._ ................. <br />No. Hours L.ibor ..............................................Cost.................................................... <br />Culin ..............._...Pavemcnt__................X........................ ..._............_.._.Sq.Ft. <br />....................X........................ �� <br />........................ <br />' . ; ' .._......._......X ........................ ..................._... .� <br />i. ..........._.......X..._ ................... ........................ �� <br />� Tolal ...........__.__....Sq. Fl. <br />— --' �-------------- <br />Remarks.._ ...............c:.....z...:.........:......_:....................................... .... -- - <br />..........................................................................................�.... <br />- ,, <br />Order Receieed._L'_ .....:.::..........::...::�•.......__..........._......................___.:_. <br />\�'orY Complcicd .�_ ___ . _... __ ._ __ <br />F.�rrman <br />