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/ �'O S�'' ���� � <br /> w.-n, ro-..-? <br /> CITY OF EV�fiETT--Water Dept. <br /> Application No.�,��.>�� llate..........�..1.........................19..� � <br /> Ins/t�I...............................incY. water service pipc <br /> For ......... / <br /> � ........4�4i_'S:z:i,�.........__........ . ...'-"""" <br /> � <br /> . ..................... <br /> On ..._.... ...... :.l...—�......._<,:.c'�u.�.�:... :�vi.................. Street <br /> Lot.......................`.'..�.�.9........................ Block No.---�---....................... ... <br /> Additiun ..................................................... ..........................................._...... <br /> Remarks ........................./.... .... ...... .L. . . <br /> � ..... . ... . .. ......................................... <br /> _..........._...........................�i. .�ire.�.sr.'�l.c��. .n.:4................................--�---- <br /> . _............_...................................................................._........--�----......----..-- <br /> ) <br /> ............................................................................................ ............................. f <br /> ........ ................................... ............................................................................... <br /> �uperintendent <br /> LABOR AND MATERIAL USED <br /> No. ' Size � <br /> .... ........................................... Lead Connectim� Comp!ete <br /> ......................._............................. Saddl^ Completc <br /> ...ft............................ ........................................................................Pipe <br /> ................... . <br /> ..................................................... Scrvicc Cock <br /> ....._.....................................:......... Scrvice Hox � . <br /> ................._..... ......__...._........I .........._.......�............._...._............_......_.�'....._.'-................_...:......._... <br /> No. How�s L�bor. ............................................Cost................................................... <br /> Cutin...................Pavement....................X........................ ........................Sq.Ft. <br /> ....................X........................ � : �� <br /> ........................ <br /> ....................X................... ,� <br /> ... ........................ <br /> ....................X........................ �. <br /> ........................ <br /> Total ........................Sq.Ft. <br /> — — ----- <br /> Re�n a r ks............................................... ...................... ................................... <br /> ................................................................................... ..................................... <br /> ........................................................................................................................... <br /> OrderReceiced.............................................................................................. <br /> \Vork Completed................................................... ........................................ <br /> Foreman <br />