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3 8 18 <br /> CITY OF LEVERETT—Water Dept. <br /> Application No. Date .........SEC...............5 19.6.1 19 <br /> Install...............................inch water service pipe <br /> For .... ...... <br /> On .............t.. <br /> .� SZ........................................... Street <br /> Lot........................................................... Block No............._.._............... <br /> Addition <br /> Remarks ................................................................................................ <br /> .............................................................................................................................. <br /> ......................................................................................................................... <br /> ...................................................................................................................... <br /> ...................................I......... ................Superintendent <br /> LABOR AND MATERIAL USED <br /> No. Size I <br /> ....................... ......................... Load Connection Complete <br /> .................... . .......................... Saddle Complete <br /> — <br /> .................._...ft....................... ...................................... Pipe <br /> .......................... ......................... Service Cock <br /> ........................... ......................... Service Box <br /> ....................... ..................... ............................................................................................ <br /> ................ <br /> ............. ....................... ..................................................................................... <br /> ........................ ..................................................................................................... <br /> No. Hours Labor............................................Cost................................... <br /> CutIn...... ...........Pavement..............---X..................... ......._.._.._.._...Sq.Ft. <br /> ................... .................. <br /> ..............X.........._............ .................... <br /> .._...........__.X........................ ........................ <br /> Total ......................_Sq.Ft. <br /> Remarks............. ................................... .... . . . . ............................... <br /> ........... ........I......... —................................... <br /> ......................................................... ....I.............................. ... <br /> OrderReceived...................... .. ...... ................... ...... ................... <br /> lVork Completed............. ........ ........ .. ... ... <br /> Foreman� <br />