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-�` �- /G72 � � - �' � _ -� <br />w. o. rcnw a . �/ : '/ � <br />CITY OF EVERETT--Water Dept. <br />/� �1,�. Date.....:..:'.......:�� ...........................19.1.<� <br />i�,�plication No .......:.:.......... .. <br />Install ...............................inch water service pip� <br />Foi..............................r.:....�........_..........._.................................................. <br />On .............:...l......:::.::....... � <br />`,—i /' ...:: : ��. �.s.i ............................................ Street <br />I�oY...::._.::.::.-,#..:.r,a.::a�.�.._c�..�.,a.F:,. Block No ...............---................. <br />. .. ,, �; �, ,. , ,� <br />< , , <br />:11�Cil�lbn ..a.�� ..w' ":� ;� ':; �>'' i :i <br />, <br />. ':� '�"' ".....:�a....__.......� ........................................................ <br />�, , , � ..,,,.3 6-. ._ ... . <br />, .... <br />Remarks.......................................................................................................... <br />.................................................. <br />. _ ..................................... <br />/��.. f ._.. .:i.= <br />..................................................................................................................."'"'...... <br />' � ,.� �...::....L.... ....J .......................................................................... <br />.....�_....../_. <br />- —,, � Superintendent <br />i . <br />LABOR AA'D MATERIAL USED <br />No. <br />Lead Con:�ection Completc <br />Saddlc Camplete <br />............. Scrvice Cock <br />............. Servicc Box <br />................. Pipc <br />No. Hours L�bor ..............................................c;ost.................................................... <br />Culin............_......Pavement ....................X........................ ........................Sq.: t. <br />....................X........................ �� <br />........................ <br />....................X........................ �� <br />............... _ _... -- <br />....................X........................ �� <br />Total ........................Sq. Ft. <br />— --_ <br />..__._ ....._ <br />Remarks............................................................................ � .......................... <br />............................. ....................................................................................... <br />.............................. - <br />OrderReceiced ......................................._.................................._.............. <br />1VorkCnmplcted......_..._._....._............_ _...__._..._.__..._ ....................... <br />Foreman <br />