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i <br /> _ , <br /> . ': � � " ' � <br /> a �. rvnnyw . , . � <br /> M'. O. IOIIN ] <br /> CITY OF EVERETT--Water Dept. � <br /> APPlication No.........n........ .... Date......1....�.......-'�.�......A..............l�.s� 1 <br /> �f � <br /> Install......�.�......................inch water service plpe <br /> For .................�.�........... . .... ........... ........................ <br /> On .................K..��..�.�.•.,......................... .. . .. ... ...... Street <br /> ... <br /> Lot.............................................................. Bloc No..................................... <br /> Additian ........................................ ................................................................ <br /> Remarks ................................. . . . ..... <br /> .. . . . . . . .. .. . <br /> ................. . <br /> ....................... <br /> ............................................. ... ��Yteti............. .................................... <br /> ........................................................................................................_................... <br /> ........................................................................ . . .. <br /> ...... ... . . . <br /> ......-.................. <br /> ........................................................... ....�.. .........:�h <br /> .......... <br /> �f�� Super lendeat <br /> �� <br /> Cn <br /> LABOR AND MATERIAL UBED <br /> _No. Size <br /> ...................................................... Leed Connectlon Complete <br /> ..................................................... Soddle Compiele <br /> ............�.1..ft._..^................... .......:..::..:.....:...................................................Plpe <br /> ................../..... :.,.t�.e.c,:c«..Lr.c. Service Cock <br /> ...................................................... Service Box <br /> ...................................................... .....................................................:......t..u..:.....d.,.._,.............................. <br /> No. Houre Lsbor..............................................Coet.................................................... <br /> Cul1n....................Pavement....................X........................ ........................Sq.Ft. <br /> i <br /> .! �_. .. ;. , ...................X........................ <br /> . �. .....__............... <br /> ....................X........................ �� <br /> ........................ <br /> ...................X........................ �� <br /> ........................ <br /> Tctal ........................Sq.Ft. <br /> ! . � <br /> Remarks...........................��.......t's.:...........:...r..,..�........................................ <br /> ... ..........................................:�.......�.z r.,...1 t....:�...1�.a......x::r:..:.(.�:................... <br /> . <br /> ...............................................3_�4�.w...a......./....f.....s�aa...�..[:Ft.cef................ <br /> OrderReceived............................................................................................... <br /> �Vork Compleled.::'...:,/,::..:. '..................... .f �....a.: .�,. <br /> ....... ..... ...1...J:.. .c r............. � <br /> Foreman <br /> --'��_ <br />