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9�,:. PRIEG�a^�� ���. . . a 'nj'///�� �{t <br />W. �. LORM l � (//`�l�l <br />CITY OF /F�ERE IT--W�ter Dept. <br />Application No...� D�'.�.. -LG�E'..K�e.. �19�..��..� <br />lnstall..... .�.�f�'-.-. inch water rvice pipe <br />= <br />For.......----- �, 7 C .`�' --------....._...... .....- ............................._-- <br />G�i ................. <br />:, o L .......... ...... . <br />nr��litiai ..... <br />?:emarks ..._ <br />— � � _ .................... Street <br />......... a.1 c:.:.. :Yc �� <br />�' ';;; ;,.k No.. <br />_ ,...:.... ........................_----... <br />._ <br />....-..� . . �.... <br />- , � . <br />� .� ....� ......................................................� y/��......_... ......... <br />,l �' r....,.__.... ; ' /y� , <br />a.- R..V.I....� ........ . ...... . <br />... l � .. ..............................._....... ` <br />---� � :-�'>'��' �� Superintendent ��, <br />C�i � `-� � �, _ -- — <br />LABOR AND M4TERIAL USEU <br />No. ' Size _• <br />Le�d Conncction Comnl^te <br />: addle Complete <br />..._ .............. ...... ........ <br /><ereice Cock <br />Scr�ice Box <br />..._._......_.I ....._.__.. <br />................ ......._......................... <br />. _ .. .......................Cos[............_............................._....... <br />Na F:ours L�bor........_ . .. . .. . . <br />Cutin........__ .._.Pavement ....................7i_...................... ....................._.Sq.Ft. <br />.. ... • , ' ........................ „ <br />: ...� ........._......._X ......................_ �� <br />�, . _ <br />� � �� � ...._ ..............X._.._................. ........................ <br />....................X... _ .. <br />................ ........................ .� <br />Total ........................Sq. Ft. <br />------ - ----- • I � . . <br />-- ( , <br />, � .�.� <br />. .. r y1�..:.....:�.� .:........ .......................... <br />P L']`lfl P1C�_....._ ......................._. <br />. <br />.. �- . .., .� <br />. ............ _.... _ _. _........._...... <br />....:..:.......�....:..... K..:..:...i...::.i:.^ .x............. <br />.. _...........""".... _ . _ ...... _.....""_ _ _ .. <br />C)f(IC'P '"'.'�C[1`'C!I...........__...._ .................._""................_........_......._............... <br />., � F� � <br />. ..; ; ..:..'_....._......._'_.... <br />.. <br />._....._:..:.. - <br />1Vnct; C:ctn�:leted.....:.....i............_ ................ Foreman <br />