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\V. �U. FORM � � <br />� / ��� <br />. � Acct. No...�.:.:; D.l. 5�.---... <br />- CITY OF EVERETf'—Water Dept. <br />Application No....%.�:..5..'r h ..... Date......... •3----.%..:�. �..`� --.........19-----.. <br />Install ................................ inch water seivice pipe <br />Lot------�------ ..........................................�-- Block <br />Contractor <br />.....................��.<'.1.�."........._----......._------....------•-----.............--------...................... <br />Amt........................-----........... Rec. No...._...--�----�-------..........---......----.....---..._--- <br />B3' ...........................•------...._--_... Y� � �. -t��n <br />--......._.---•-------.... ..... <br />5uperintendent <br />ShopRemarks........._--.......---•--.......----- ....................................---------�--.......... <br />Work Completed. <br />- -+c_ - _— - ..... <br />. ...........� <br />Foreman <br />