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... :. PRICFIC 3M / � � � �� J . . <br />�V. t�. fORM 3 C� .. _ <br />CITY OF EVERLTT--V�later r�ept. <br />Applicatimi No...... ... __`...: ' .`. � ' Dbte... ..:,.: �-�: %:'r. ��.......�......19_54:� <br />iastall ...........................".inch wa[er service pipc <br />For......................... ..... ....... . . . . / . . . . <br />J�—�` n /_... _��7:%:Lr �.-� :.:t-� � Street <br />._..... ._...... <br />........ ............. .. .. . . . <br />On........................ ...% i- - -......... <br />/ ; <br />Lot............... ............................................. Block No..................._................. <br />nr;dition ..__......_._......._ .................._....................._..........--........................ <br />Remarka._ ...................._................_- - - - _ <br />........ ...... <br />_ ............. .......................................... -......_._......_---..... -... - ............... <br />Superintendent <br />LAROR ARU hSATERIAL USI�D <br />No. Size � <br />.... `__ _...---.---_.__—_.—_ _.— <br />_ ........................�.........----I Le,id Conncctim� Camplete <br />__.........._......ft.l.........� .................i Saddlc Completc <br />I <br />_ _ ............. ..... ... _... _..... _..... _................. _ _..._......... _...........Pipe <br />. ..................._.............................. Servicc Cock <br />........................_._.._._..._............I �cr�ice I3ox <br />No. Raurs I.abor ..............................................Cost.................................................... <br />Cut in....._.........._Favement.........___.....X ........................ ....._._......---.....Sq.Ft. <br />....................X........................ �� <br />........................ <br />. .........Y ........................ „ <br />......... . ........................ <br />__._......._...X ......................_ �, <br />_ ........................ <br />Total .................. .....Sq. Ft. <br />------- --- -------- ---.._-- <br />- -----_ <br />Remarks.._ .........................._...........--..................._.....................-- ............ <br />......._............_ ........................_.......... _....._...:............................................ i <br />OrderReceived .............._.................._.........................._...__....................... � <br />�Vork Completed........._._ ................_..... ............... _ _ . _....... l <br />Fareman <br />