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3� % r i <br />„ �; <br />��� W. 1.Form�1�� � � <br />�� CITy FEVERETT-•-Water <br />COF'F K <br />Dept. <br />Application No..I...�T_3_'�... Date.._ ��i'Y/_ �....___19� � <br />� Ins�t�ll�....-�� ___ mch water sen�ice pipe <br />For...!_�:: .�. � .�.d{.—Pe-+�/...._ . <br />..._.._ .. ....._.. . ...__.... <br />��� /1���� G� <br />On......__.�.la...L..�.....<Y�=+¢=tli.Y.Y�!!�i._.._.__.... -------- Jtreet <br />Loc_ ...../.....�.�._....�.........._ _... Biock No. ___� _... <br />... ..........__ ......__.._ <br />_ / • � <br />Addition ./.. �R���i..�...%_�='Z � � <br />_ ... _.. ..... . .._..... <br />Remarks.._ _.._.�_.._ _._.... , <br />--- __........_ _ ..._ __ _ _. . _........_ _ ..........._... <br />. . _._ <br />_ _.__ .. . <br />� G� <br />,..,. o�l�,-<d...__. <br />s�or.:�� �, <br />-= =_ = - _ _G�?� _ ��� <br />� ���� _ <br />LABOR AND MATERYAL USED <br />� - — r'�- -- -- --� — <br />No Si:e _ <br />-- . _._____ _. ._____ .. ..__. <br />..... .I � .. CAnit ;.'bn Qqmple[c . � <br />' `. <br />�... ... .I .. /u ..� L ' � e Complate <br />�_ .._ (t 7....'�w ' _... . L�..�".. �,{[—�, �... /. ......Pipe ' <br />-3 " �Se�`w`�c'"x�Cock " <br />J _.. !yp .Q � <br />( .._... �...Y_ .. Scrcicc Nox lf � /-"�� ' <br />.a _ . .. .. .-�jy° . , _�r- ya-P+� �.-'. C iCo �.%.^ . (� .7.. _. . ._.__ . _ ..._..._. <br />_ _..... ......._...... _..._ _. I ___......__...._ ................_.....___..........._.............._..___._. ...._ _....._....__..... <br />_ _._........_. .� ._.... ..I _......... ._........_. .__ _. _._. .... . .._. _._. .. ........._ ...... __.__.... <br />...._ ._ ......... .. ........ ..._ . i ....... _.._...._....._. . ._.......... ... .--.....__ _ ... . ......... .. ... ........_... <br />t:o. Hours Labor ___.__ . ._.z..._...Cost.._.�.��-'"%..__...... ....._ _..._._... <br />Cut in . ..._._.__ .. . .. Pavcment __ ....._.......... X � .........._Sy. Ft. <br />. .. _....._.__ ._ ... ............ <br />-/Iy� X ...__ .._ .� <br />D"' _ . _. _.... <br />� � _ X . ..._. .� <br />. .__. ...... <br />� ' . � ... _ X . . . . . . �. <br />_ _ _ <br />� �. <br />Rcmarks <br />_ __ <br />Ord�r Rcccived <br />Work Completcd . <br />Total ....__......_.....59. F[. <br />__._.... ._ _ _.....__ _. ............._. _... <br />......._ .__._.....__..... _ _ ... . .............. <br />_ _ ........ <br />. . . .: ... . .... . , <br />� _. Fo�.m�� <br />