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i <br /> 1 <br /> I <br /> � :'7�.�� ' , `,' �. <br /> w. u. ronrla <br /> - • CITY OF EVERE�"I'--��later 'Jept. <br /> Application ATo.��._:;.._',. - 5....._L......................19..�_ .', <br /> :.. ..:. Date..............: . <br /> /f� Instal�.................�_.. .inch u ater service pipe <br /> F�r ...._`..�-�...-._.!/.......M.r....:c...�.:...�;:.i.`.:........................................._. <br /> .� _ ' /'i //6.::r:..........:I:.,.C./.. StT2PI � <br /> �_� , � <br /> nri ...............G.......�..:.............�.:::..:.�:.....:,.::.,, /. <br /> TOf...........................__................................ BIOCIC ArO..................................... I <br /> Addition <br /> .............._ -.....�............_.........................._.__.................. <br /> Remarks � � <br /> ""..........................._L. �.:Y._�.c...:l.,:.:...................""' <br /> � ._..1.L.:..:...:.. <br /> ..........................."""............................"".._......................................................""""'" <br /> .................................................................'""..............""""....................................... <br /> _._..........................................'"""......"""...........................""'"".............._................... � <br /> . ........................................................................................................""'.............. <br /> Sup2rintendent J <br /> LABOIi ANU \fATERIAL USED � <br /> _ No. � Size I <br /> _i--- <br /> ._._..................._�..............._....... Le:ii Conncction Complete <br /> ................................................_..... Sn�i.�le Complete <br /> .......................ft............................ ..... ...........Pipc <br /> ._..................................................... <br /> ........._.................._......... ...._....... Setvi.e Cocic <br /> .................... ................ ._........... Ser�:icc Bax <br /> No. How�s Labor_....._......_....__.....................Cost.................................................... ' <br /> Cutin_.........._._....Pavemcn!........._.--.....X...........__......... ......................_Sq.Ft. <br /> ....................X........................ �� <br /> --....._---.......... <br /> .............._X........................ ,� <br /> � ........................ <br /> ...................X........................ �� <br /> ........................ <br /> Total ........................Sq.Ft. <br /> ------------------ <br /> Remarks........_......................................... .._...................................— .............. <br /> _..........._............................................_........_...... ..............................._........ <br /> ............... <br /> OrderP.ecciced.........._....................................................__........................... <br /> \4"or}� Completed_..................._ ......_.....____....-- -__.____.....__..._........ <br /> Furmna <br /> I <br /> iu <br />