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�v. o. �nnr� ��� � �� �� _ �J,��/,��t_ <br /> CITY OF EVERETT--Water Dept. <br /> Application No./_ :::'._%_'?,- Date......�i.r.::r...� ....19..1�. •' <br /> � ................. <br /> � <br /> Install...............................inch water service pipe <br /> I'or ........:..:.....�.....,�:t,a.F.�.:r..:................. ......... <br /> ............. <br /> � „ ................ <br /> - �, . / <br /> n .............�: > - .,�7.f�_ . <br /> .............c.......:::.'. E�..�..t.:.:..>.•�—.-.. Street <br /> .... . <br /> ...... <br /> Lot.............................................................. Block No..................................... <br /> Additic n <br /> .......................... <br /> ............................................................ <br /> . ........ <br /> Rr.mxrks . ...:.��':.`.Xa:a.r.�.,�.._.................. <br /> ............................................ <br /> ........................................................................................... <br /> .......................... ................................................................................ <br /> ................................................................................................................ <br /> ............................ ................................................................................. <br /> Superintendent <br /> I.ABOR AND MATERIAL U3ED <br /> No. ..... Size I � <br /> — — <br /> -- � ---�----- <br /> .-....-........... ................. . 'ead Cnnnection Complete �— . <br /> . ........................ ...................... ..i t;addlc Complcle <br /> ._....................tt................_........ � ..... . .....................PiPe <br /> . ....._................................... . <br /> ..__............................................... Service Cock <br /> ._........................ ........._ ._.......... Servire Hox <br /> ....... .................................... <br /> .._....................... ..... ..._............� <br /> .......................... <br /> No. Hours Labor............__............................CosL...................... <br /> .........._.. ............ <br /> ut in._.. .... _. Favement .. .. ..........X........................ <br /> . . . ........................Sq.Ft. <br /> ..... ...._.._...X........................ �� <br /> ....................... <br /> .. .. ._ _..._..X........................ �� <br /> ....................... <br /> __._...... .....X........................ „ <br /> .......... ........ <br /> Totnl ....-�........ Sy.Ft. <br /> —�—�— .—r __ . ._:------ <br /> — - — — <br /> --- <br /> emark::.. .... . ... . ..............................._. ....................... <br /> ................... . <br /> ...................................................................................... <br /> ..... ............................................................................. ......................... <br /> Order Hereieed __.... ._...... . <br /> _ / <br /> ..._.. . <br /> \Vork Complcted _ <br /> . ... . . ..Forrrn;in <br />