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� - /�.S'7� .��_ , ,.�;,�� ��� <br />r,. o. ro�r a ,J / � � / ��i : ( < �: . . l <br />� CITY OF E��'ERETT--Water Dept. <br />Applicetiun No.1..:Z..''. :� `.%. Date...........�'..::..1.......�....:r:..._.....1�J...... <br />1�stall ...............................inch w�ter s:rvice pfpe <br />For........................................................... <br />On .........�:..�r'..1�:...r........�:.%•..�1......Gr.....�::.c...�.e�...:�..'...1.�9treet <br />Lot.............................................................. B1ock No..................................... <br />Additian..................._.............__................... <br />.................................... .......... <br />IZemarks..... .. ............................................................... <br />� ........................... <br />...... <br />L/ �.1.. — <br />............ � � ................ <br />.................................................. — -- <br />i....._ ..................................... �---.................... ....................................... <br />.......... <br />�.+ ...... :..... ."�....f.: :..:1./..:�f..c�..........._..............................,...._........ <br />...................... ........ <br />� . <br />--....... <br />..... ....................................... ........ .. :...�...`... : � , , <br />.. . <br />6uperintendent ,;� <br />��—.— .,_ �Y^;�. <br />LABOR AND MATERIAL OSED �c <br />-����� ��- -�-........I Lcad Connecdon Complete <br />.......................... Snddle Cnmplete <br />............ .............I .......... ... <br />• . ......... ............................ <br />................._.. Scrvice Cock <br />........................ Servicc Box <br />..........................I . <br />. ....... ....................... _................ <br />..........................� ......................._.. <br />.............................. <br />.................Pipe <br />...................................... ... <br />......... _ ............................... <br />.......... ................ <br />No. F{oura Latwr ..............................................Cost....................................... <br />. ... ........ <br />Cul in..__......___..Pavcment ....................X.............._........ ........................';q. Ft. <br />....................X........................ �� <br />....................... <br />..__...._........X ........................ �, <br />................... _ ... <br />......._...........X ........................ �� <br />........................ <br />Total ..................._...Sq. Fl. <br />�—..____-- -- - <br />----- <br />R emarks ... ............................................................ . <br />.. -- <br />............................... .. ............................. <br />............... ... <br />.... ... .... ..... <br />........ <br />Order Received . <br />lVo:k Completed. . ...._ .. <br />_. _ _._ ._ <br />Foremtm <br />