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\ I <br /> � , <br /> W.D.Furm� iM�.19�7� • n�-s <br /> 5.].Y:ie6e � <br /> CITY OF EVERETT--Water Dept. <br /> COP��K <br /> APl�licnd�nNo. -:--=---°— , Da,c -- -----'----�/------19--` <br /> � , Install.______ ______inchwaterservicepipe <br /> For --— — --- ------------------------•-- <br /> — ------------------ <br /> On- ------------------ --- -- -------_. - -- ----- ----- Strect <br /> Lor --- ——- -- `--� ------------ Block No... .- --- -------------- <br /> Addition -- -- ----- ---------------• -------• ------—---------- <br /> Rematks -------•---- - ----- •- --- '------------- <br />' ----------•---------------------- ------------- ------ ----- <br /> --- ------- ------ --------•---- ---- �---- ---- -- --— -------- <br /> ----------- �--------- ------ ---- - ----- -_. .. ---- �---------- <br /> -------- - ---------- ---- -- --— '-— -�-`-`-- <br /> Suo�'rintendent <br /> LA��OR AND h[ATERIAL USED <br /> — _—.—. _—_ __—___—__ _—__. ... <br /> No. Sizc <br /> '_'""'_""'"'"" ""'_'"""_"""' Leay Connection Complcce <br /> '_"_'_'_"'"'_ _'"'"""'"'"'... Sad��� Compi_rc <br /> '_""'_'_""""(t.l.""_""_'""'" ___"' _ .. ...__""""'_"'""'__'Pipe <br /> ._.'.____""'_'._."__'__""' Scroicc Coc,: <br /> __"______'_._' .__"'______"_ Service Dox <br /> Nu. Hours Labor.__'___'________"'Cosc'_________"__"_'___"'___"'_""' <br /> Cut in'_"__""'Pavemcnt"'_"_"'"'X_'"'__""" _"_'___'""'Sq. Ft. <br /> '___'__"'""X"""'__'_"'_' �� <br /> _'__"'__""' <br /> _'_"'_"""a __"___'_'"_ _"'_"_'_'_" .� <br /> _'__""""X__"_'_"'___ ,� <br /> __"___'_"__'_ <br /> T. •I Sq. F�. <br /> Rcmarl:s------------- -------------------'---- ---- ------------- <br /> ----—------------ ----- '---------—'-----—•----------------- <br /> Order Receiccd _-�----------------- ---------- - --------- - <br /> Work Completed- ----- ----- ---- ----- ------------- ---- <br /> ro�,�.��.� <br />