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5631 BROADWAY 2016-01-01 MF Import
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5631 BROADWAY 2016-01-01 MF Import
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Last modified
1/24/2017 9:12:18 AM
Creation date
1/24/2017 9:12:07 AM
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Template:
Address Document
Street Name
BROADWAY
Street Number
5631
Imported From Microfiche
Yes
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� <br /> 1 <br /> ; <br /> ✓ ✓ <br /> — �� 72� - — f'r• 7fl? (� <br /> w. U �owrn a <br /> CITY OF EVERETT�--Water Dept. <br /> �i�e,c�!-. � /� y�, d.� 1 ise� <br /> �p}iee}iem No.. ._1....._.... ... Date................................................19...-- <br /> Tastall.._ .........................inch water service pipe <br /> For .......:� ........�... c-..,.....�2-r.�:S..:rZ.L........................ <br /> �G.3.�../;�Cl:�.:-4s..rt?.r%�t.�..... Street <br /> On ...._......... <br /> Lot.............................................................. Block No....._............................... <br /> :lddition ..._......_- -.......................--.._........... <br /> _........_.......... ................. <br /> Remarks ........ ............................................................�-�-�----.....................__... <br /> ....................................................................................................................... <br /> ................................................................................................................ <br /> ..................................._..._................_..........._--....... .............._----....----...--- <br /> ...............................---..................--------...... <br /> .................................................... i SuPerintendent <br /> LABOR AND MATER/AL USED <br /> N,�. ' Sixc � __— <br /> ---- ---j <br /> ....._..... <br /> ._...__....................... ........ :.cad Connection Complete <br /> ..........................._.............. ........_ Saddlc ComPlelc <br /> ..................... <br /> ..ft............................ ._......_......__...................................................PiPe <br /> ............................ <br /> .........._.............. Service Cock <br /> ......................... Servicc IIox <br /> ... ......... . ........................_.........._........ <br /> i ._..._..........................................._. ...............__........................... .. <br />� ...................................._......_................... <br /> No. Aours Labor......................._.....................Cost........._................................._.... <br /> Cutin_...__........._Favement.................._X..........._........_ ........................Sq.FI. <br /> ....................X....................... ......._............... <br /> �� <br /> ....................R........................ ......---............... <br /> �� <br /> ...................X....................... ........................ .� <br /> Total ........................Sq.Ft. <br /> ---— <br /> -- Remarks....._.. .................................._...._............_............................................ <br /> .......................................... <br /> OrderReceiced .............................................................................................. I <br /> \Vork Camplete�...................................................................................._.... <br /> i Foreman <br />
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