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5 1 �.ic6e�M i.�2' �5 � � � ' " J�� ` �' j � ��'�� <br /> W.U.Fnrm J <br /> CITY OF EVERETT--Water Dept. <br /> l � ';�: � /�� X ...is.G�� <br /> rlpplicationNo.....:............`.... � e.............................. ............. <br /> Install......`�J.............inch water�ervice pipe <br /> , y <br /> FOL' W.!...- .,.... 7.'G.,_l.�<:..�J................................................... <br /> ............ r �:.-- <br /> Or. ..............`I. � ' �1::'.�,�:h.^.J....1_.::..�:..:._::.:1......_.... Street <br /> _i .....:--...:j. <br /> Lot.............................................................. Block No..................................... <br /> Addilion ............_............:r--...........- ......................................................... <br /> ; <br /> 3ema^ks ....._1�..!l..L•--.r;::!,iye.-................................................................. <br /> l <br /> ...................................... ...................................... ...................................�-��--- <br /> .......... ............:.................................................................................................. <br /> d'� ........................... ' . _, �, <br /> .. <br /> ............. , <br /> ...;..:....._....:..._.... ........ ..... .. <br /> ... <br /> .... <br /> ...1 r �� � ^ i i.�.:...... ...1..��... ' _ <br /> ......... ..... ...... .............. .�....� . ..�.�................ / � <br /> Superintendent � <br /> y� r <br /> � � LAR(:I{ ARD hi9TERiAL USF.D <br /> � <br /> -- No.-- _ Size -.----_ _ <br /> .�................_. Le,d Cormection Complete <br /> ....................... ..I.. <br /> ........................._............................I�, <br /> ;addk ComPlete <br /> � ..................................Pi c <br /> .......................ft.........................._i .._.................................. P <br /> ..........................I...........................I Servicc Cock <br /> ......................................................I <br /> Secvicc IIox <br /> ...................................................... ................................... ........................................................................... <br /> ...._._..........._.. .................._...I ._......._.._......_..........��._....__...�� .................._......_..__...._.��-�--..�..... <br /> No. iiours Labur..............................................Cosl.................................................... <br /> Culin......._...........Pavem.rt...................X........................ .._....................Sq.FI. <br /> ....................X........................ �� <br /> ........................ <br /> . <br /> ....................\..............._....... ........................ <br /> ....................X........................ ............. <br /> ........._ �� <br /> Total ........................59.F:. <br /> - - —---— ---.—_— <br /> ---- ---3'�—y /-n - � <br /> Ret`tRCiis..J........::?..1. ...... . :� . . . . . . . <br /> .. ..:...�.....'... .... ... ........................................ <br /> ...._...__...............................�...........:..............................................."""................. <br /> ..... <br /> OrderF,r_ceiced.................... ...............................................:._...,..........�.... . <br /> _, , . , - „ <br /> . , ;.:...._. <br /> `-._� `. � ' <br /> �Fork Clomcdeted..�Ll.. �.....�.,k............:.... ............ ... _. <br /> • Foretnan <br />� � <br />