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� <br /> I <br /> ��� ,� i ' <br /> w. o. ,o ,�. <br /> � ` CITY OF EV;_�E�_,Water Dept. <br /> Applicati�n No,�_::i, 5 � _� ' <br /> ......_�.s..: Date............:�.....:/.:.. ....................19r,:.:. - <br /> ; Install...... ,.:............ .incF <br /> i �r, <br /> "''- water service pipe <br /> . .� , . / i <br /> Ol `._..�. l...`..k.:......_�n::..:i.c=.rt,:;...�. <br /> . __ <br /> . <br /> . ........... <br /> nP. � �. .: . . � .-.i ..............' ...... <br /> = .................. <br /> '...�...�!........ � . � � ........... <br /> � ........ , . __ ., <br /> .:......:...:.....::..:....:.::...: � .`� .. Street <br /> Lot.......... .....::...:.�.......... <br /> .................................................... Block No.......-..-......... <br /> °ddition ................ ............... <br /> .............'..�:. <br /> F.t=ivarks �, j..........................._�... <br /> .................................. <br /> _�_ <br /> _...........................:. � � <br /> .._..r..�. . . <br /> „ <br /> ....:..._.::�.. r� <br /> -:..:'.1................................. <br /> .....""'"............................................. <br /> Sunerintendent <br /> —�— <br /> LAA71L ATp nTaTERIA --�-- <br /> USED �---- <br /> —�—.N iz—e i— <br /> `__-- ,�� <br /> --- --- <br /> ...._............... ._..... .._......I Lead Cennection Comple,e —'— <br /> ............... _._I.._. . �ddle Complete <br /> ...........i................. . ' �c <br /> ___ I...._.................f t.._.................. . <br /> ......................................................................Pipc <br /> ._._..__.................... ..... Sr.rvicc Cock <br /> .......___I <br /> ........................... <br /> .......................... <br /> ervice Box <br /> .......................... ........................... <br /> .............................. <br /> ......................................................... <br /> ....................................... <br /> .................................................... � .................................................................... <br /> ..................................................................................... .... <br /> ........................... .........................I <br /> ........................... <br /> —�__--�_ ............................................. <br /> � � � .................................................... <br /> No. ?{ours L.3bor........_.................................... <br /> Cut in......_............ Cost.......... <br /> ........................................ <br /> �avemcnt...._..... Y........................ <br /> .......... ........................Sq.Ft. <br /> ....................X........................ <br /> ........................ �, <br /> .._,..........._..X........................ <br /> ........................ �� <br /> ................_..X........................ <br /> — ---�_--._-- Total .._.—_'="_'�_. �. <br /> ----_ <br /> P.etnarks. _ _ ..__................_S <br /> �--�__ q.Ft. <br /> ........._...._................................................................. _�_ <br /> . <br /> .... ........ ......................................................................................... <br /> Order Reccived................................................................................ <br /> 1Vcrk Completed... ......... .... . .. . <br /> _.._.....__.._.._......._._.. <br /> _.__......... . <br /> Foreman <br /> i <br />� �. �, _ r <br />