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16 FERN RD 2016-01-01 MF Import
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16 FERN RD 2016-01-01 MF Import
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Last modified
4/12/2017 10:43:37 AM
Creation date
2/10/2017 4:46:03 PM
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Template:
Address Document
Street Name
FERN RD
Street Number
16
Imported From Microfiche
Yes
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W. D. IO�M ] k/����` _ � <br />CITY OF EVERETT..�7tlater�Dept. <br />Application No..���_`l.��� , Date.......�;�,,.-�, �� <br />.........................19 l. `l' <br />Install ...................„_..... .�ch water service pipe <br />For.._ ...............__.,.................... <br />�ti........ ..� ............................................... .. . . . <br />// .. ... <br />On ...... �..:_'.........�'.. �.n�;r�:.4��... <br />'i ............................................ Street <br />Lot.............................................................. Block No.......................---........... <br />Addition.......................................................................................................... <br />Remarks ........_.__ <br />Superintendent <br />I.ABOR AND MATERIAL II3ED <br />_No. Size I <br />:.ead Connection Complete <br />Saddle Complete <br />"""" �"""�•- Service Cock <br />....... <br />...................................................... Service Box <br />No. Aours L3bor ..............................................Co�t....................... <br />Cut in ....................Pavement....................X........................ ............................ <br />........................Sq. Ft. <br />...................X........................ �� <br />........................ <br />........................ �� <br />.............. ........................ �, <br />Total ...........Sq. Ft. <br />— --- ............. <br />Remarkc <br />� <br />OrderReceived ............................................................... <br />�4'ork CamnIPtPA <br />Foreman <br />
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