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Q 7� ���v�.J�. <br /> � <br /> w. n. ron a � <br /> CITY OF EVERETT--Water Dept. <br /> , - . , , �: .� <br /> Application No/:.>�.l.J.f.... Late..._..�....�.............................19...... ' <br /> For ......... . :� `/�t�l.. .C,:. :.�'x4 �..�`..:�`rh wa...r ser,vice pipe <br /> . <br /> /� � �_...� ✓��c�................. <br /> � / <br /> �Il ................... ..... .._ F.<.:.lz.._L:'.s.c:..................... Street <br /> Lot...................................................�----... .. Block No....................-----•---.....-- <br /> Adilition ................................................................................................ ......... <br /> Remarks ................................ ... . .. ........ .. - <br /> ... ...... . . . . . <br /> _.. <br /> .................................. <br /> ................................................ ./.�!J.:'v..tS�JC.(�Ci .4f.:?..`...................................... <br /> ...................................................................................."""'...........................""'... <br /> .......................................................""'................................................................"' <br /> ........................... ........................................................................................"'..... <br /> Superintendent <br /> LhBOR AND MATERIAL USED <br /> No. j Siae � <br /> --- — — <br /> ...................................................... Lead Conneclion Complete <br /> ...................................................... Saddlc Completc <br /> .......................tt............................ ........................................................................Pipe <br /> ..................................................... Servicc Cock <br /> ...................................................... Ser:icc Box <br /> .............. <br /> .....................................................I ...............................................................................................................- <br /> No. Hours Labor..............................................Cost.................................................... <br /> Cctin....................Pavenunt....................X........................ ........................Sq.Ft. <br /> ....................X........................ „ <br /> ........................ <br /> ..................... ........................ ........................ <br /> �� <br /> ....................X........................ .� <br /> ........................ <br /> i otal ........................Sq.Ft. <br /> -- ---- —— <br /> RP m a r ks.................................................................... ........................................ <br /> ........................................................................................................................ <br /> ............................................................................................................................. <br /> OrderRecei��ed............................................................................................... / <br /> \Vork Completed.......................................................................................__. � <br /> Foreman <br />