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.b�;:N;i�� � � '� . _ . S/3 y <br /> CITY OF EVERETT--Water Dept. <br /> C�� '/ _/ <br /> Appllcation No..�.�..1...h.X. Dat . �a �`� IA:�.! <br /> . . ........_...... <br /> ........................ . <br /> �nst 1........-�) ...5�,� h wa�f r�rvlce pipe <br /> I�'or ..................... .r....l�:...��y'..N...:.�!:�:�!:.�-(�/ �,..... .._..... <br /> i•;';, <br /> On ..................._ti....:�:...�J.........L.S..:O.�SJ.:::�-:�.:�k+!'r.::4�.�1�..�.i:l�treet <br /> Lot.............................................................. Block No........_........................._ <br /> Addltlon ................................................. ......................... <br /> ` ......._........,.j;. .... <br /> Remarks ..............�..�.��5� �,.�:l:!,:�:e_:!+..�....-'•`.!�: U <br /> .......................... <br /> ........._�'l.L.tM�.*.!�.t.�...................................................._.........._.._....„. <br /> ........... <br /> ......... . �},U...................................................._.._....... <br /> ........... <br /> .. <br /> ..................... . �....� ...�,.................._ . . .._... ... <br /> � . . . . . .. . <br /> r �� <br /> .................... .._.... <br /> ...a,.0 �) ` <br /> ...... . .....,.... ......:........ .............._.....................�...�Cl..._.�� <br /> � �i •" &apermt�ndens <br /> .: � <br /> °� R �+nro �u�surl oeen <br /> e �� <br /> No. e, � -� <br /> ............._............_��,,,,,r,�,�!. . I,eed Connectfon Complete <br /> ..................................................... Saddie Complete <br /> .......................tt_......................... ..... ........................_.......................................Plpe <br /> ..................................................... Scrvlcc Cock <br /> ........................... .......................... 3crvlce Box <br /> ................_..........._....................... ..................................................................................._........................... <br /> tio. Houre Labor.............................................Coat.........._.............._....................... <br /> l:ut In....................Pavement....................X..........._........... ........................Sq.Ft. <br /> ....................X..............._. �. <br /> . ...... ......._............... <br /> ....................X........................ ........................ " <br /> ...................X........................ �� <br /> ......_............... <br /> Totel .-...................,9Q <br /> Remarks... ................./�� - .P't <br /> . <br /> .. <br /> . y.................................................... ....... <br /> ............. <br /> ............. ...................................:......................................:�.1... �.'.�..�..�....... <br /> . ,.. <br /> ...............................................................................::...:.. <br /> ,.r'..��,:.�r....................... <br /> Order Received............................ 1.................................. <br /> � J � �F�.................�.:..:... <br /> 1'vork Completecl.�...(`....:. ................................................................. <br /> Foreman I <br />