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�� � o g ---- _- --- --- <br /> .,. o. .o.�! � " <br /> �y�i`� <br /> CITY OF EVERETT--Water Dept. <br /> ApplicationNo.,./...C./...�'..Y.... QD�ate.............;1?.:z....1�:...............19.N.;3 <br /> Install.........�,.Y.............inch water service pipe <br /> For .......:'`.�....-`•,r 4::...,r;c:�.�..�...--......... <br /> . ........... ............................................ <br /> � = � ��' ..� <br /> On .........-.�..... ......:�.:S.fi?..�......................................... Street <br /> Lot....................... ..................................... Block No.............................-�---... <br /> A�idition .......................................................................................................�-- <br /> Remarks ...._��.:��-�— �..�:x.:<s�c:. <br /> ................... ..._.c_,............--•--................ <br /> -�/�c.c.�..... _L 4 <br /> � <br /> ...............................................:�.,�..r......................................................----• <br /> � <br /> ..........._.�....:,....._..................... .............................................................. <br /> .... ,�:? <br /> '� L � � <br /> ..........................�..'---.. �.. <br /> O � � - ................................................ <br /> .................:.. ' � .. .... .......... ............� <br /> . ... <br /> ti°�-..........i.. ... f....�i................. .._;�;'. i�`-�r. <br /> . . ir. • . ................�'--- <br /> :;., � ��� '� . � � Supe:intendent <br /> — ' )h � _ <br /> LAEDR AND MATERIAL IISED <br /> _xo. s�:� L <br /> .................-...................................I Lcad Connection Complete <br /> ...................................................... Snddle Complete <br /> ..............�:.....ft......:.:_::�.:............ ......:.................................................................Pipc <br /> .....................::.........�..:.:................ Service Cock <br /> ...................................................... Service Box <br /> No. Hours Labor..............................................Cost.................................................... <br /> Cutin....................Pavement....................X........................ ........................Sq.Ft. <br /> - ....................X........................ ......._............... <br /> �� <br /> ,. � <br /> .= <br /> � ....................X........................ �� <br /> ......._............... <br /> ....................X........................ �� <br /> ........................ <br /> Total ........................Sq.Ft. <br /> Remarks...... ......:........... ................................................................................ <br /> .................................................................:....................................................... <br /> .....................:_....:..:..�.:..:...:...................................................................._........... <br /> OrderReceived.........................................................,.................................... <br /> �Vork Completed.t._::..........................................:...::.:.:::..:...:..:.::............... .. <br /> Foreman <br /> r_ . <br />