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De Valle Co. To <»t Dr. 0
(/)
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::u
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C
192_ -I
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z
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MONTH DAY TIME DESCRIPTION OF WORK DONE
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2 1/
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-'-r
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TOTA L
o. Days per day, amounting to
o. Days at $ per day. amounting to --
Less
r ,ess for
--
Amount due I
I
Appro\'ed by R ecei,-ed Payment:
Foreman (Sign HNe)
Supt.
