2111 20TH ST 2016-01-01 MF Import

{y� � 0 U (/ S J.PricoclM7.ao29Ay' ] � � ' ' _ F'. U. Form 3 � V CITY OF L'v LRETT--Water Dept. _ _ . r, r;^ _ i - , ...�s...... 9pplication No..., ..._� ....:........ D•ate:: _..........:........._................... � install.,.;..� ::..... ............inch water service pipe ,. , , . . _ ....................................... I,�,, . --,_. .... -- ................................ � On ...........::.:l1.1...........----......: -�..r::..._��::?......_........_.._......,.... Street: ,r ��/ `f Lot................�.��....."...l..l:.................... Elock No..................................... rlddition..................._....._............................._............................._......._....... Remarks.............................................. ........................................................... upermtenaenc � �, LA[SOR AND 11tATlRTAL USCD No. Lead Conueclion Completc Snctdie Complete ...................................................................... Pipc 5ervice Cack I Service Bos � ....__.....__.._. ......... _ .... ... .... ........ _ . ... .. _. C o s t......... _................ _....................... Nn, Flum�s L.:bor . . . . - Cut in....._._...__....Pavem=nt.._...._..........7i ........................ __............_......Sq. Ft. ....................�i........................ ........................ « ....................7i........................ ........................ �� .. .................X........................ ........................ „ Total ..................__liq. Ft. -- � � Remarl:=.. ,�J.�.... i _. _.. _ ....................... _...............................--........................... . o � ....................... ......................... Order P,ecei�•ed...._ .............._................................................_,.... . ...4.... / , , . . ......... .. l',•'ork Cott:plcted....:'....�.�"...i....._ ......................._........_..;. � . Fotem�n