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. � j ,�,. � 9�-� - . ,. ,;� � <br />��, <br />w. o. roqM ' <br />CITY OF EVERLTT--Water Dept. <br />Application No..r/� % y.�.::%:�.. Date....:: �' ( ..::.................... .. ......19_�.,� <br />� , <br />7nstall ...............................inch water service pipe <br />' "-' _' _' . <br />IP or ....... . . �; . . , <br />.-. � ... y �_� o i r : - t . <br />. , r .......... ........... .. . . . <br />. - <br />. ... <br />On .. ......._ ( �� ...' % .al.+G � �r - �'-�� Street <br />........ . .. .... <br />Lot ...............�,,...f.1i.L: �.. (�. �..:L,............. Block No.............----........ ---... <br />.... <br />F ddition <br />.......................................................................................... <br />Remarks................................................................................�•---..................... <br />........... .................. <br />......... .. ................... (; .... `_....'. _ ............. <br />/ ................... .......• <br />, . . - ' - <br />...................................._�_...:..:r.-.� = �-��k . <br />.......:.......� --- :...... ..............---�- �--....... <br />.._ . ................... - - - � <br />. , ,._ L <br />.....................................�::: �_::,.. <br />, -,� . < > <br />.-. ........ <br />�..' . ...s„ � e�u <br />F <br />__— //L 1_. . <br />LABOR AND MATERIA�. USEII <br />_ No. j Size j�� <br />�-��-��--���•�•-�- �-� -........- I Lead Connection Complete <br />, <br />...................................................... Saddle Complete <br />� � .......................ft............................1 ........................................................................PiPc <br />........................ .................... Service Cock <br />.. <br />.................._.................................. Servicc Box <br />No. Hours Lsbor .............................................Cost.................................................... <br />Cutin............_......Pavement ....................X..................._... .._.................._Sq.Ft. <br />....................X........................ ,� <br />........................ <br />....................X........................ �� <br />........................ <br />....................X........................ ....................... �� <br />_ Total ....................._�q. Ft. <br />— -- ------_ <br />Remarks ............................................................................................................. <br />........................ ................_............ - - <br />CrderReceiced...._....._ ....................._�.._................._............._- ............ -'. � <br />\Vork Completed ............................................................................... <br />. . ........... <br />Foreman <br />