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_�3Go� � _ <br />8. J. OXI[Pf <br />M'. O. (ONM ] <br />��� y� <br />CITY OF EVERETT--Water Dept. <br />.��E' ° <br />Application No.... . _`:'' .'. �.. � Date...........�.. ,-r..`.... � �...........19� ./ <br />I�stall......... ��,£�...........inch water serv/ice pipe <br />F�C ._._L^..,{G[..r.Gf.l..... �.. ��.�'....iL�:O1.E�,:nf/J..;S{i.J.....c�LTG....... <br />On .._....._1'//s....;�«:1`^�...._ ................................. Street <br />1 <br />Lot........./ ..................................................... Block No..................................... <br />:!d:iition ...._........ <br />.............................................^ ....................................... <br />Remarks ... .. ,z� ..�...-..... ' <br />,,�- . .c�z�.u::cK::% ..................................... <br />��-�<=-4. �-� <br />.................�...:......... .......�^�-��............................-�-� ........ -... <br />3' <br />.., ��..�.3 :........................................................._... <br />.�--... � � � -�• <br />,(_V . ! dk ...........................: � ��.f.�`�f.-::rr� . ... <br />j� ♦ <br />' I;'� ,� Supe[intendent <br />�" ���' - rh�J <br />No Sixc <br />---- -��-------- <br />............................._...__..._ _ .. <br />......................._ . . . <br />.. .. .......... ........... . <br />...............f.;l..ft _,:._�:L..............I <br />:,/ , i <br />..................�...... .._.-...._ .._..I <br />'�OR A�D \2A9'ERiAL USED <br />Le.i�i Conneclion Completc <br />S:u _Ic Complelc <br />... ...'::....: �... ':.::_ ..............................._..............PiPo <br />Servfce Cock <br />Ser•: icc Box <br />. . . ........................................................................._....................... <br />..._.........__ ................................_.............................................._....... ..... <br />................... ........................................................ _ ................................... <br />............................... ............. _........ .................................................. _. _. <br />No. N.ours L�bar ..............................................Cosl............ <br />Cutin......._...........Pavem_nt ....................X......._............... <br />, <br />� ,, i . . ......._ ........... ........................ <br />�� ' .� � .�' . ,�' .__ ..............X........................ <br />�----....._ ............. _. _..... <br />........................Sq. Ft. <br />.......- ............... �� <br />....................X........................ �� . <br />........................ <br />Totat . ......._............Sq. Ft. <br />------ —/--- — <br />- <br />Remark;......... _ ...............b.._.1.1.;:....,:..:..... ..... .............................:............. . <br />�. <br />,, <br />, <br />' • •...,.�._:�....,,..:,-.:. <br />. ....... ... _ _.......... _..,,.:.....: ::........ ................................ <br />..................................... �'.....::�..i.:.5..:................................._.........._....... .. <br />Order'.?eceiced .................................................... �./�.......:...-•---........... <br />\VorY. Complcted.��.-./...!-/...-�.�............,�.:...:.:.:.L.:_c;_ ............... <br />Foreman <br />