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71 U <br />CITY OF EVERETT--Water Dept. <br />Application No..oYN.... Date. ..6 <br />... .... '2 ..19rSti <br />� In�stall............ _-? ......, .inch Water service pipe <br />For .........��5::-L"l.:�rLL.:.--- ....11 <br />On...................... ./...10.............u. ...... Street <br />Lot.......................... ..a 6 <br />.............. . Block N ............-_....... <br />g <br />Addition ...................... - .......... <br />Remarks ........ <br />tw,I Superintendent/ <br />ABOR AND MATERIAL USED <br />No. <br />Size I <br />................. _........ <br />.................... _..... <br />_ <br />Lead Connection Complete <br />............. ............ <br />....._...... ....... <br />..... ...................... <br />............... <br />Saddleqomplete <br />...�C� w................__... .........._.._......._.Pipe ' <br />.... ........ I........... <br />....X1................. <br />Service Cock <br />............... L.......... <br />............ _.. L.... _... <br />...... �.:.I�............. <br />.... .,�.t 1 ............. <br />Service Box . <br />.. .. <br />................I.._...._....i._::............. <br />....(%..................._......_.._.._..»................._...._..._._..........._ . <br />No. Hours Labor ... .............. ........._.................Cost..........................._......_............... <br />Cutin... ................. Pavement ................... X............ ...... _... ............... _....... Sq. Ft. <br />...... ........... x................ __... .. <br />.................. x................. _... .. <br />.........X........................ �. <br />Total ........................Sq. Ft. <br />Remarks... .......................................................................................................... <br />OrderReceived ................................................... _.............,..{.J........................... <br />4ork Completed..I....��...... .... <br />! <br />................._.-.�t...... ................... <br />Foreman <br />