Laserfiche WebLink
CITY OF F VERETT—Water Dept. <br />Application No../ .._... Date ............. ...........19...... <br />install ........................... _..inch water service pipe <br />For .................. <br />..................... _.......__......... <br />...... <br />.... <br />.......................... <br />.... <br />.... <br />.... <br />...... <br />On..................:ii...:-..._7....:—....................................._. ...... Street <br />Lot............................................. ........ ...... Block No ........ ... _.._................. _ <br />Addition................. ..................................................................._.................... <br />Remarks ._.......... ................... <br />ir.�.._...._..:.............................................__...._.._.._._ <br />LABOR AND MATERIAL USED <br />Lead Connection Complete <br />Saddle Complete <br />................................................... .Service Cock <br />........ ..... ..... Service Box <br />No. Hours Labor ................... _... ......... .... ..... cost ......... .............. ....._.._......_....... <br />CutIn....................Pavement.................... X....... .............. .......................Sq. Ft. <br />.................... X........................ <br />Total .................. _—Sq. Ft. <br />....................................................... <br />Remarks... .. .. <br />............................................................................... <br />....................................... <br />............................................................................ _................... _....................� <br />Order Received ........ <br />Work Completed....._. _ . _ ...... <br />Foremaan <br />