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_ ��. o g ! _ ��� - �G J � <br /> w. o. ro�n a f <br /> CITY OF EVERETT--Water Dept. <br /> A lication Nd /6... � � � / '` <br /> PP I�-... ��.... .... Date........�r.t.._-.�................19..4:',d . <br /> 7nstaIl.... J . inch wa:er service pipe <br /> / ,.a............ <br /> , /`� r <br /> For ......S.c.l.:.�:F:.�.�:::..... . .�. .t.:<,. �:t��..•�:'c..:..............,./._...... ..... <br /> / - . ... <br /> Or ................ ....`�:�...�.�.....i...� '...zt.l.�sX:<Gf.�.�-/C(v.� Street <br /> Lot.............. .....��..-•---.....................----.. Block No.................................... <br /> Addition ........................................................... <br /> . . . -- - - • <br /> Remarks .i���F..!-F�.r.i.[.<.r�..L:/../..._..-...�.;.cr..:.c..::�::........................ <br /> ................................................ . <br /> � .-�, ;� .�xC��._�...Y;�'rYr..................................... <br /> . <br /> .................:.........�........................... <br /> � ��-t <br /> �......:......�y�,.�...............---................. <br /> ... ..._..,.....::.......�.. ................................................... ....... -_.. ,�.s:.� <br /> , . ... r^.:�� <br /> /� r !/ ���-�`-, ; � <br /> .._.. ... .'""'............................ � �USi� <br /> . . . . ........................................!I• <br /> ��_;... ....w...........�."' """ <br /> `,/Su?erintendent <br /> I,ABOR AND MATERIAL USED <br /> ..........No. .Size <br /> ���••••����-•-�-� . ......... :.cad Connection Cor.�plete <br /> ......................................................� Saddie.Complete <br /> ..............:::......it....._..................... ........................................................................Pipe <br /> ......__.......�............_.:................... Service Cock <br /> , �, r•'� - <br /> ...............i..................`.....:............ ServiCe BoX <br /> No. ftours Labor..............................................Cost.................................................... <br /> Cutin....................Pavement....................X........................ ........................Sq.Ft. <br /> ...................X........................ �� <br /> ......._.............. <br /> ....................X........................ �� <br /> ........................ <br /> ....................X........................ �� <br /> ........................ <br /> Total ........................Sq.Ft. <br /> R emarks..............:..:.:....................... <br /> ................................................................. <br /> .......................................................................................................................... <br /> . y _ <br /> , , ........................................................... <br /> OrderReceived....._......i:.............. .:.............................................................. <br /> ., <br /> \Vork Cnmpleted._�.::..::.:....:...�.�>..........................:...:........:........................ � <br /> Foreman <br /> '+��� _�... <br />