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3510 LOMBARD AVE 2018-01-02 MF Import
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3510 LOMBARD AVE 2018-01-02 MF Import
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Last modified
2/22/2022 8:11:25 AM
Creation date
2/17/2017 8:42:27 PM
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Address Document
Street Name
LOMBARD AVE
Street Number
3510
Imported From Microfiche
Yes
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9. Jf.PRILBC YM 410 <br />M'• �. FORM ] <br />CITY OF EVERETT--Water Dept. <br />Application No..2.1 :_F..... Date .............. .......... <br />- <br />Install ......-��........... .inch water service pipe <br />For.......... ........ ................ ........... ..........-.. <br />Or....... [x-..._; Lk—rtr. .r.... ................................. Street <br />I.ot............................ _.........p........-.._. Block No.... .................... ........ <br />Addition ' : rasc> . £ r. _ `t................................................ <br />./..[�..........................Y._. <br />Remarks-..�45�: i...�Y.-.-.-.... ....-......._.. <br />...... ..................... -----•------------- — — <br />LABOR AND MATERIAL USED <br />No. <br />Size <br />............. ............ <br />................ _........ . <br />Lead Connection Complete <br />............... ....... _.. <br />......... ................. <br />Saddle Complete <br />.......... _.!Z"... ft. <br />_.._.._ Lefif.-...... <br />................. .................. ........ PiPe <br />...... ....... ............ <br />.....�'24,:......... <br />.......... .._.._..-.-. <br />Service Cock <br />........................ <br />............. _.I.._..... <br />Service Box <br />No. Hours Labor ..........................._.. -......._.....Cost..._...... ----..........._.._.-_..............- <br />Cutin .................... Pavement ..._.._..._._.. X .................... • .....................Sq. Ft. <br />/!-7 ................. X................... ....... _-............ R <br />V.n.................... .......... _........... ........ ............... .. <br />Total -. c„ Ft <br />............. ............................ .......w:.f.Y^.. IrA..-...-....-.--.-....................... ...-.....-. <br />Order Received....................................................../.......�..� <br />y......-.-_..... <br />Work Completed.i.. ...............r/ L. .............. <br />Foreman <br />
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