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- � OG.�"�'G - - `7 ��, <br />w. o. ronw a /`.� �� ti.. <br />CITY OF EVERETT--Water Dept. <br />Application No...:.�.�E.:�. � �. Date..........:_:... � .........................19.C. �1 <br />Iastall ...............................inch water service pipe <br />I�;�r ................................................................................................................... <br />/c-�........_e.::.....:�..�'...<::�; ....... ............................. Street <br />� _� <br />On ........:.. .... . <br />Lot.............................................................. Block No...........-•------..............-�-- <br />Addition......................................................................................................... <br />Rcmarks.................................................................................................... <br />................... ............................................................. <br />...................................................................................... <br />......................................... ........... ...................................................�--........... <br />Superintendent <br />LABOR AhD MATERIAL USED <br />No. ' Size I <br />— - � <br />......................................................I Lcad Cormection Complete <br />...................................................... Srdd'e Con.p]ele <br />.......................ft. ........................... ........................................................................Pi pc <br />..................................................... Servicc Cock <br />...................................................... Scrvicc Box <br />_ .... ... ................i . . . ----- � -- ------ --------- -_._...... <br />No. Hours Labor .............................................Cos:................................................... <br />Cutin ....................Pavett�ent....................X........................ ........................Sq. Ft. <br />....................X........................ �� <br />....... _ ............... <br />. ,� <br />..................... ........................ ........................ <br />....................X........................ �� <br />.................. ..... <br />Total ........................Sq. Ft. <br />-- — <br />Remarks ............................................................................................................. <br />.......................................................................................................................... <br />......................................................... ................................................................... <br />OrderRecei��ed ............................................................................................... ( <br />\Vork Completed ............................................................................................ <br />Foreman <br />