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���,�.:��„2 i � a <br />w. o. roew a ' . �J�G // <br />CITY OF EVERETT -W�ter Dept. <br />Application No.._/�� /'%n. Date:........_...�..-�.rar--� �c- - lg � � <br />s/ J..... :..._........_ . .. <br />lnstall......._`.:� i..........inch water service pipe <br />For .............�G�_,_ 7Z _/" ., _.., ' <br />On......... <br />Lot.......... <br />Addilion <br />Remarks <br />.��� <br />n... �...!`.., <br />r. Q,....:_'� <br />��l'J�r+ ll I Le�G� � <br />Y � ��� '�"w� <br />�.k� .O�--y�.$� <br />c;it N i� <br />No. I <br />LABOR AND MATERIAL QSED <br />Stteet <br />Superintc�dent � <br />�nti <br />•-.....-..•••_......._� Lead Conncclion Comp]ete <br />........................ SaddleComp!ete <br />' : ,. i. <br />� � ................. .....:a.. _...:.:..:.:.......... ......Pipe <br />............................ _. <br />..:.::::.............. Setvfce Cock <br />% ..................... Scrvice IIox <br />No. Houra Labor ..............................................Cost............ <br />Cut in ....................Pavement.................._:......._......_....... <br />>. , <br />... , . ,. ,. ................... �C..................._... <br />, ,. <br />- ....................X....................... <br />Total <br />........................Sq. Ft. <br />".....- ............... �� <br />........................ �� <br />........................Sa. Ft. <br />; --.. <br />, , <br />.� , „ , <br />................. �: A r.: _!............ L ....:..... . . <br />.... �...... F ................ <br />7 <br />......................................................ti:....�.1:1.1.G.11...................................... <br />........... <br />OrdcrPeceived ....................................................... ................................ � <br />.: 1...� .. <br />�Vork Comp]eted...r::.I. � ::.a.f ::.................._. .... �_i_i..l. � + � t................... / <br />�y Foreman <br />