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w. o. ron�!a��D � , <br /> CITY OF EVERETT--Water Dept. <br /> . <br /> Application No..:.....;.._,__. .:1 Date.............:.�..........:............ ........19...... <br /> Install...........__................incF r.atcr service pipe <br /> � � , <br /> y'or -. . . <br /> .� . . ...................._......,......__... .......... .................. <br /> ........ <br /> , . � <br /> On ......_.....:.........:...........:.'_:.::..:..L...:..:_, ............:..:.... _................. Street <br /> Lot ............................................................. Black No..................................... <br /> Addition <br /> ....................................... ........ ....�...:.......................... <br /> , , . <br /> Rcmarks ...................................C.....(...::;...:...:f.,.....:. C..:c..:.,....................... <br /> ........................................................................................... <br /> ................................................................................................... <br /> _....._............................. .................................................................................. <br /> _............................ .............................._....................... ......._.............. <br /> Superintendent <br /> LARUR AND MATERIAL IBED <br /> No. Sizc i <br /> _—' ... .. ._ .L_._. _.._ � . .. '_'_ .___— <br /> _—___ <br /> � I LeaJ Connection Complele <br /> ....._.............._...._....... .._._. _.. _. <br /> ..........................I...................._. _ Snddle Completc <br /> ......._.............St.................. __._. ..._____.._._..._ . ._..........._._.......................PiPe <br /> _...................._........_...... .. .. ._._. Scrvicc Cock <br /> ................_....... .. ............__....._ Servicc Sox <br /> Na. Hours Lnbor ___. __._.___...__......._.._.Cost.....__.................... . <br /> ._.__..._...... <br /> C�d in .. 1'avemrnt . . . _......X ...__.............. . .........__........_Sq.Fl. <br /> . _. ........_...X........................ ,� <br /> ........................ <br /> _..... ._...X........................ ,� <br /> .. . .._............__.... <br /> . . .._......._X_...................._ „ <br /> .._............._.... <br /> Total .......__....._. ._..Sy.F[ <br /> ----_—.. _ . __ . . . – -- --- --- --_" .--� -------�_ <br /> Remark:;... _._. ....._......._................_........_._.._..................._...................._. <br /> ....... ..........._ _.............. ....._........................._ _..._. ..._......................_.._... <br /> __..............__.......... ............_....................................................................._....... <br /> Order 2?ecci�rd __.____ . . ......... _ ___. <br /> _ _................. <br /> \bbrN. Cnm�•�Ictcd_. . ._. _. _. . . . . .. . / <br /> Furrman <br />