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�.��,�� � ,, , -,, . <br />, <br />w. u. ronH <br />� `CITY OF EV�RE7'T--Water Dept. <br />Application No.�.:.:'..._':..'<'.1' Date .................t�..... <br />. �..� ....................19.!:: : .l <br />/� / /,�Iastall........:� ..........:.........inch water service pipe <br />For ..�....1"sr.:c.:t`.1. � , / �, % .,_ <br />�.:... .............- .r...:....�..,._..__. . <br />� - � c1 ��.._.-- ., - ._�_....... <br />........ ....... <br />, +. <br />On ...........1....%_�.I.:..........s....C.-::...t..l.�.:::......._... <br />. .....:.:._,........ treet <br />Lot............................................ � -•--.......... Block No...................................._ <br />;1.r{�i1LIOR ..................................................... <br />. .................................................... <br />Remarks .........._ ................ <br />.t .......................... <br />............... - ----- ............... <br />... <br />�- <br />....- ..........................._. _. � , <br />1....1.i...:......a.'_.."""..:.....L.f:. <br />� . ...._........."""".._.......__'""' <br />................................ <br />_ .............................. <br />.. ..................._.._..._ ........... ............................_....................._._.......'_".. <br />Superintendent <br />LABOR ATD MATERIAL USED <br />---Pio_ _� Size I <br />.........................................._... I Lead Connection Completc <br />......_.__ ......................................... �addlc Completc <br />_......_............fL ........................... _._......................_......................___...............Pipe <br />._..._ .... . . ........._........_.... Survicc Codc <br />. _ ........ .._......._ _._ ...................... Service 1 �ox <br />...........................�...........-------- <br />................................ .... <br />............................. <br />Vo. '.tours L:ibur ...................... .........Cost. _— <br />.............. . ......................................... <br />.......... <br />(.ut in........_.__.__Favcaicnt......_._ _......X ........................ ........................Sq. Ft. <br />....................X........................ ,� <br />........................ <br />..................._Y........................ �� <br />........................ <br />....................X........................ �, <br />........................ <br />Total........................Sq. Ft. <br />------ --- _---= ---= =— <br />� -----_ <br />P�� m a r ks .......... .............. <br />............................................................................... <br />_... _ . . ....... .................. _....................................... _..........................-�-- <br />................. ...................................................................... . <br />` ........................ <br />Order�?ecciced .................... _ ..__......_ .._...._.................._,...................... <br />��'orY i:mnE�leted_..........__..... '� <br />_ _ _.... .____....__._._...._ ..................._ .. <br />Foreman <br />