Laserfiche WebLink
CITY OF EV// ERETT--Water Dept. <br />Application <br />/E� Date --------- /-{-=�-'--��.:.19`.�. , <br />No._ <br />�}�t�Jl...: _.::.. inch�ivater service pipe <br />For ........- C.....!' C;, : <br />On ...... p},.=.:3-••--�"'^ ... Street <br />Lot . ---------- <br />Addition .............' <br />-----•----- - <br />Remarks .... - <br />-------------- ------------------------ -------- <br />..--------— -- � /--- <br />- '— -�-----l----C:--------C-� <br />LABOR AND MATERIAL USED <br />No. <br />Size <br />. __-__._............. <br />------- <br />Lead Connection Complete <br />...__..--- --- <br />----- .--------- <br />Saddle Complete <br />.. 1 .. it <br />------ <br />-- ----------Pi e <br />_______________ <br />_________ �. <br />Service <br />........ <br />Service Box �__� <br />--------------- <br />-------�_.__. <br />....................................... _ ....--_-_ <br />No. Hours Labor .................... <br />Cut In------------ Pavement _....._.._ ._._........ ...........-... Sq. Ft. <br />------------ X-------------- ............... <br />�. <br />Total ----------- _. Sq. Ft. <br />Remarks --------- ------------------ -:----------- <br />----------------- — -------------------------------\S.- <br />- <br />Order Received------ •--------------------- ------ <br />Work Completed ------------ --- ------------------- - <br />