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� <br /> I <br /> . � .���.�o� ,.. Q g • t /i'I <br /> w. a roww o <br /> I Y OF E�ERETT-�Water Dept. <br /> Application No..._��..�.I....f.�.L. Date..................._��!�..__....19��` <br /> �/.. -.-....I all.............�.,`�.....y3 inch water service pipe <br /> For U.t�,aJ �-s-.�C.a.cJ _.4 �� <br /> .......... .. ............. <br /> . �J-..........................................-��----_....----- <br /> On ............-�--`>U-•��- -----........_............_..................... Street <br /> Lot.................--------��--�---....._......---..... Block No....._....-�------....--�--......-- <br /> Addition ................... ._........._...----�-----...........................-- �- <br /> . ......--`----_.. <br /> F.emaxks .---�-�. ........ ......._.=`c.���.--�n'e""i 3 � <br /> ..._....--•-�-�•------._....--------�- <br /> .------�- ........--�7-t`'`=--�--�--'`.'..__.".f-.R�:'�!r�::st�s�........_-----.. <br /> .......--.... .............. ... ............ . - - <br /> _...................._. _..---�---........_. <br /> _......__-� -_....__: . . .......-------�------..... <br /> - <br /> .... - - -...-/,. ,>�r"s� ......................... ..�'.�.......��.�........�.�.�`..�.�� <br /> � /;�c /��"".�..""""' Superintenden�� <br /> V -"'. <br /> I.ABOR AND MATERIAL II$ED <br /> No. Size � <br /> ..................................._........._...._� Lead Connection ComPlete <br /> .............................'........................ Saddle Complete <br /> -�--...----..._...fC._---........._......... ...........----...........----.....................................Pipe � <br /> ....----........------�......................... ServiceCock <br /> ............................................:......... Se�vice Box <br /> No. Houts Labor....'.........................................Coat.................................................... <br /> Cut in....................Pavement....................X......._......_....... <br /> -`...............-....Sq.Ft. <br /> ....................X........................ ..............---....... �. <br /> ....................X........................ ., <br /> ........................ <br /> ....................X........................ ., <br /> •----........_....... <br /> Total ........................Sq.Ft. <br /> Remarks. -- .......... ..- .... ----.....--...... ...- ... - ----- <br /> _ - --....__.......--� ... - ...... -.....� -.... ................- - -_........... <br /> ........._.._...-� ......_........_...-- ....--------� --� .......................- -....... <br /> OrderPeceive3-----------......._-----------------...--------------------.........--�------ <br /> �Vork Completed.....- - .:.........--.....--........-- .... ---.........--��-- <br /> Foreman ` <br /> �ir <br /> � <br />