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i <br />� <br />� <br /> ����� � � . <br /> w. o. ro�N a <br /> CITY OF EVERETT--Water Dept. <br /> App]icationNo...IG./_..�.�J:. Date._��r��..::.`:�:..._�.._19�� <br /> / '/ . <br /> � Instya�ll,.....5:'._.........,..........inch water servue pipe <br /> For .....,\�/..�.4.s:"4.........C�.�L-�.: ........................._..................................... <br /> � . <br /> On ................._:�_Q:�.�,.,.._...... .�:.f:�%G� Street <br /> '_.............................. <br /> Lot.... ....................................................... BIock No......-----................---...... <br /> .4ddition ...:._.._................................................................ <br /> ............................_. <br /> Rcru�tks ...:... . .. <br /> � � .. <br /> ............... ............................... ..... . .... <br /> ......................�.--�A-�-va-c.c.���.e��,..J � ...�-^�r1.L•L_.�-1.�tJ <br /> � L .................:...........'_"............. �. <br /> �.L��-!.i.:�........."................ .. �'............_. - ... "' . <br /> y�/���/ y/� ................ .....................+........................... <br /> i/ . 1... {... 4�U �� y— `� �.i !l'7�tn�c.'�.1'+ <br /> _..u......__..... F.. ........ ._. A-.f:S,6L�.'f.-:.L(._�t�:....:........_..-.-r.. .. '�y.1 <br /> 14�..�.4!.�J� � �--E.t-� <br /> ...... .: . .............._.......... � h <br /> .... , � l <br /> � }" . ... ....""" ""(/ <br /> ' � � ��� �� � O ���/�'��P���ndoh,'� x <br /> � �<•.�� <br /> r z� — „ <br /> • <br /> � . , LABOR AND MATERIAL USED <br />� �, "�` . No. ' Stze <br />� 'Y ' S — <br /> � �•.......-.•................... _I iead Connection Complete <br /> .. . ':.�., . � ..........._........... _..... ...... ....I S�ddle Complete <br /> - ..._.... ....._tt................ ....... ..._.._.......................-----......................_...........Pipe <br /> �,, ;�,... .. ..................... ...... .. ......... Scrvicc Cock <br /> ,.r'.r;:;.;.. ...................................................... Service Box <br />„ .� 'v.�-1._. <br />, �•-:_._�.:.; No. Y.ours Labor..............................................Cost................_....... <br />� -.-- .......................... <br /> .. _ .,.. �� _ <br />'�..,_..=... Cul in...._..............Pavement....................X..............._.._.... ..._...................Sq.Ft. <br />"�.; ._;..- �� <br /> . �.l ....................X........._............. ......_................ � <br />� ,��, <br /> �.: ���-` ......_....._.....X..........._........... �� <br /> - . ..... ...... . <br />�` . <br /> i � . ......... ..X................. . . .._. ..... �� <br /> Tolal ............ ......_.Sq.Ft. <br /> Remarks......... ... ..._........................ . ..... .. <br /> ........................__............--.................................................._.................-- <br /> '° ..................................._....................................---.................._.............._........... <br />, _ Order Receiced...................,.!�........................................._......... a_....... <br /> ��P,v ' /9"Cy �rn� .�k.L, <br /> \Vork Completed............./..!..:................��/......--..._..................._....... <br /> ,� Foreman� <br /> \ <br />