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W�DErmiM;-�:2� II� �Z ' ' �il �7 <br /> CITY OF EVERETT--Water Dept. <br /> I / ,, / , <br /> Application No.....�./..f..y!/. Date. ............................�:�....5..�..19>`� <br /> Install..........._���`�......inch watet service pipe <br /> . , <br /> For ....:......�.....---..�.. ...........,�.,.: .�..[r.�:t1.........................-------........ <br /> ' !a....1..u!........`�:d,!::::�:'.�.:._��,..'.-...._�.e........ St.reet <br /> On ..........._.......ly.- <br /> L,ot.............................................................. B1ock�No..........---�--..................... <br /> Addition .............................................................:... ....................................... <br /> Remarks �'lV , J ' '..::).�.1L..'.:..�.:!�._./ <br /> --....------ --. ...:.'r-........-------- ---------------• <br /> .......................................... ................................................................................... <br /> ..."._ . ��,(�pj�) -I,� <br /> ..... ......LJ....:._...�.......:J.......�.Y V.................................................. • <br /> . .................................................:....�. <br /> � ��` <br /> /......'.. <br /> ' -..u'..... . � •` Y / <br /> ^ � ,�� , , <br /> ....�....y...............�.,. .�................................_.:.......a .----�- , <br /> ....._. . . :.. <br /> �. '1 L�'� Superintendent � <br /> ��. � <br /> -� ,� LABOR ATD MATERIAL USED <br /> No. ' � . �ize i _ <br /> -----.�_ � . <br /> ......._............................................I Lead Connection Complete <br /> ...................................................... Saddle Complete <br /> .......................ft............................ ........................................................................PiPe <br /> ...................................................... Service Cock <br /> ........................... <br /> ......................... Scrvice Box <br /> ................:_..a............................ ............................... ........................................................................... <br /> ............I_...._................... ......................_.._.........._..................................................................... <br /> No. Hours Lnbor..............................................Cos[................................................... <br /> Cutin.............. .....Pavem:nt....................X....................... ........................Sq.Ft. <br /> ....................X............... ....... �� <br /> ........................ <br /> ...................7�........................ ,� <br /> ........................ <br /> ....................�i........................ ........................ " - <br /> Total ......................Sq.Ft. <br /> _— ------------ — — <br /> Remarlcs�Q..�...,.,�.��.....�i:'L .h�:`c..::................... ........................... <br /> .................................................................................................................... <br /> ........................................... ....................................................................... <br /> Order Received.......................... ................... _ J ....... <br /> .. .. . . . <br /> --..... <br /> � l' <br /> .�r..�, ..�..��, .r � t � <br /> ..... <br /> \'�erk Con;p!eted�-.:./�. r...�.[/....._✓1._..�...... ,/. _.�..c::::.::::.�.... <br /> Fr:emnn� <br />