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8218 5TH AVE W 2016-01-01 MF Import
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8218 5TH AVE W 2016-01-01 MF Import
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Last modified
4/3/2017 9:58:42 AM
Creation date
4/3/2017 9:58:40 AM
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Address Document
Street Name
5TH AVE W
Street Number
8218
Imported From Microfiche
Yes
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� <br /> w. �. roarn .�� I iP � ' • ' <br /> CITY OF �VF?RETT.--Water Dept. <br /> APPlication No.:�...._..'.,'.:..�'._ Datc............-....... ......:.:...............19...::. <br /> � instal:l...... .......................inch water service pipe <br /> %' / i <br />� For __.. i...:._..........L._.:_:......:..:-�'-.....................: ....... ' ....t....... <br /> _., i(�' � � _...... �................. <br />� Lot...�...Y�{..��J�- ... ..._........_.....'.'..... B!ocfc N`.:.!....:............. S reet <br /> On �_ ✓ <br /> o........................ ... .. <br /> �rfdition ......................._................_. . <br /> _....... . ............ <br /> . . <br /> ..---� ..................... <br /> Remarks .................. ... ......._�._..,�__:._....__.....:i..��:.....:.:........................... <br /> ...._............................_................._. <br /> ............... ............................................. <br /> , , <br /> -:.:.:.................:...................................................................................................... <br /> ...............'...:......._...._..............._...._..........__._- ........................................ <br /> ............................... ....................... ... ....__......................................_...... <br /> Superintenden[ <br /> LABOR AND MATERIA� USED <br /> Na Size i <br /> ----------------- <br /> ........ _......................._.._.._.._......I I.ea2 Cnnnection Comple(e <br /> ............._........_.........._ ___ ...__.� Saddle Cmnplete <br /> ...._._..............ft................._......... _............._....._...__.................._.....................Pipe <br /> ..._......................_....................... ..ervic� Co:k <br /> ._....................................._........... Scr✓ice Box <br /> ....................................._.......... _. ........................... .._..._............................................................_........... <br /> .................................................... ............................ ........ ....................._.................................................. <br /> No. I[ours L�U�r.............................................Co;t.................................................... <br /> Cut in. ............._._Favement....................X............_._....... ........................Sq.I�'t. <br /> ....................X........................ ........................ �� <br /> ....................X........................ ........................ .� <br /> ...................X........................ .� <br /> � Tntal .._........_..........Sq.Ft. . <br /> ---------- -._----- ---�-------�— <br /> ---- <br /> P.ema r ics. .........._......._..............__...._........ . <br /> ........................._... <br /> . , , <br /> :�.._,-. , ..e <br /> - . . , , <br /> _. .-.-,�.,...�..�,a�......:................:...-------- . ...................................... <br /> ........................................................................................................... .................. <br /> Order !ieceived.. .._........... ................._......_........ ...._......__........... ......_.. <br /> \Vork Com�leted .. ................ .. _._... ..._. . _ ... _ _...................... .. <br /> Fc rc:nan <br />
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