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- . <br />/ '7 � � � �i�i�' <br />w. i. row/a� <br />- �-CI'i'Y C+r EVEi�ET�'--Water Dept. <br />Applicatiun No /:=',���°... Date........._......CG.,:;�:.._:�........._19c:�.%— <br />Install........_........._ _...... .inch 'a�a'ter ser�•ice pipe <br />. <br />For ����' . ,••J�art;.� ...................................................... <br />........ ..... �.........., � <br />: .� <br />On .................iP-�.3...._/3�j�...�:..y..-=-:.:L1..;.:•.:....'::.}:..::.-'r- Street <br />i,ot......._............_ ...............................__... slock No.---................................ <br />:? ddition .. ................... _ _ .................................... <br />................................... <br />Remarks ..... �'f�'..j��'m...c.�-..:.. :............ <br />................................................. <br />... ...................... <br />No. I Size <br />.................... .... ........ .............................� <br />LABOR AND MATGRIAG US�D <br />-- <br />................._..............................._..I Iead Conr.cction ComPlete <br />........................ <br />..............................I Saddlc ComPlete <br />......... ............. f t. ........................... I ... ............................. ---............... <br />..................................................... Service Cnr.k <br />.....................' Service IIox <br />........................... .... � I <br />No. Hours Labor ............................... <br />Cut in...._.....__..._Pavement............ <br />� -- <br />Superintendent <br />........................59. Ft. <br />........................ �� <br />....................X........................ ........................ <br />�� <br />.._.X . ................. ........................ �� <br />Total <br />....................._.Sq. F't. <br />------ <br />Feriarecs... ......................._... <br />...................... .......................................... <br />Ordzr ?Zeceice9........... <br />F1ork Completed....... <br />.�.....� ...._...._.. _� <br />^oremar. <br />