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, <br /> _ . . �'S� 3 � . � --�_ <br /> S 1.Pri.6NM7d62 ' /'' <br /> w.n.Fo�� �', 1 a/J <br /> CITY OF EVERETT--W'ater Dept. <br /> ,- � �- <br /> ApPlication No.�i_v .J� Date.................................� ...5.....19S.0 <br /> Install........._.�.�..�.....inch water service pipe <br /> For ...........-�--�................................................................................................._. <br /> -:, i � . ,_- :-- <br />� On ................�..�.�'...�_:..........,!:.:.__::'..::..'.......(j-.........------....----. Street <br /> Lot..............................�---............................ Block No..................................... <br /> Addition ....................�................... ......................................_.......---.............� . <br /> , .� . . , : <br /> Re::.a.-ks .............'�_�.1.:.------:::.:�!.:s�.:.��.,.«,�.:.................:....:_.�I:1f.......!..�,�<.: r <br /> ......................................................................................................._.............._... <br /> ....................................................•---.........................................-----�-••---......_.._.. <br /> ............................................_........----............._......_....................-----.,..--,•-r-...._ <br /> � <br /> � ' � <br /> �. <br /> ............................................................._.......................... � . •... . . <br /> .......""'--.._.........."".... . <br /> Snperintend�nt ) <br /> � <br /> LABOR A:JD MATERIAL OSED <br />'I <br />� No. Size � <br /> I ..................... ........................... Lead Conneclion Complete <br />, ........r........_................................. Saddlc,�ompletc � r <br />� ........�.:.........ft._......................... ............�L�.r.�:,:�.`.L::.�..............................Pipc <br />�l ...................................................... Service Cock�. <br />� ....._............................................... Snrvice Box ' <br /> II ...................'-................................. ............................................................................. <br />. ................................... � <br />�� ................................................... ..........................................................................._................................... <br />� <br /> ............................._....................... ................................................................................................................ <br />� _.................._................................ ................................................................................................................. <br />� No. Hours Labor..............................................Cost..........................._..................._. .. <br />�, Cut in.._...............Pavement....................X........................ ........................Sq.FC. <br />') " <br /> i ....................X........................ ........................ <br /> �� <br /> N .................... ........................ ........................ - <br />' ,� <br />� ....................X..........._........... ....................... <br />' Total ........................Sq.Fl. <br />� - _ <br />! Remarks............................................................................................................ � <br /> I, .._.................................................................................................................... <br /> I ................................................................................................._.......................... <br /> OrderReceived.........j...............................................................:................. <br />. �r> � � ^ � ' � <br /> l �Vork Completed...:'......:..?..`._.1�.C.:�..........._r........._?..�....:..c�..l...:.:�....� , . <br /> Foreman / <br />