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<br /> CITY OF EVERETT--Water Dept. ! �q
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<br /> Application Nd...........�:...... _.. Date..7:... ` .................:_�.........
<br /> �' I ...inch water servic� i e
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<br /> Remarks .............................
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<br /> � �1. LABOR AND MAT'ERIAL USED
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<br /> _�Lead Connection Complete
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<br /> .,..__ S..ddle Complete
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<br /> No. Hours Labor..........................._.................Cost..........._.............._......--'--...........
<br /> . ....Pavement._................X...._................... ........._.............Sq.Ft.
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<br /> OrderReceived.................. ..................................................... ....................
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<br /> \Vork Completed...:.....:....L1.G:..Y..1..................... .. . Foreman
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