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/� I �6 � _ J <br />� W. L, fQflM J <br />ACCL. I\ 0........... <br />GTY OF EVERETT—Water Dept. <br />Application No-..L . �:..'�1..1':.... Date......I.SI�.I��.:. �.._- .................19.,.�.i <br />�/ i � . . <br />Install...�....`..� ................. inch water ser��ice pipe <br />Owner.............................- ............ ....,............... ........... . <br />.... .............:......��.`'%. ............. ............ <br />. ..... <br />Address......�7..�.� �. ��' <br />Lot.............................................................. Block No................. <br />Addition ......................................................................... <br />Contra ctor ..... ................/. ....:......................._-..................................-�----.................... <br />Remarks..------ %` , � �'r <br />�_:`.'..F.:........�" .........................��..5.:� .............................. <br />................... . . ................ <br />.. <br />..... . . .... ............ <br />Amt..-� -•-�� --.:................ Rec. Na <br />Shop <br />^t� Z_� <br />Work Completed..........1 .................... <br />Superintendent <br />Foreman <br />