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-. =-./ g3 7 7 . �- . . - - • ✓r <br />w. u. ronw a �/,i: 7/ <br />CITY OF EVER�TT--Water Dept. <br />Application Nd..�•� r� bin.� 7 19�2 <br />� , .... Date ................................................19...... <br />�- 1ns[�n,l�.�. ...........................inch water service pipe <br />For ....(11..��.........`�/..t,�l../..:.Lr.:'Y..Y..L{�:.�L.� .................................. <br />/,/ - , ' � <br />On ..........11'...U'.../._�.....r.`�Lc'k....... .. .�7 ...:.............. Street <br />Lot............................................................. Block No......---.........._................ <br />Ad�lition .......................................................................................................... <br />Remarks........................................................................................�---............. <br />� <br />. ....:i:.:..:' ..:...E. c.S ................ <br />... . _ ... .......... ..................... ...........................................................__"'--.""_.. <br />Superintendent <br />LABOR AND MATERIAL II9ED � <br />No. Size � _ .... <br />.....................................................I Lead Connection Complete <br />..................................................... Saddle (:omplele <br />.......................ft............................ .................................................... <br />.................................................... Service Cock <br />...................................................... Service Box <br />No. Aours L�bor ..............................................Cost.................................................... <br />Cutin ....................Pavement....................X........................ ........................Sq. Ft. <br />....................X........................ �� <br />....... _ ............... <br />....................X........................ �� <br />........................ <br />Total ........................Sq. Ft. <br />Remarks ................................ ....................................................................... .... <br />........................................................................... .............................................. <br />� <br />OrderF.eceived ............................................................................................... ( <br />\Vork Completed ........................................................................ .. .......... <br />Foreman <br />