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B. J' PPICtlC � I V • �1 � V� <br />W. [�..�OFM 3 /5L5 / � . <br />CITY OF EVERETT--Water Dept. <br />- , � ='„� � �sa;>. <br />�— :.,�, <br />.K�p'ima.i<�n. No..././....1..../....�Date....._ . .............._._...._...............19...... <br />�' `� I ut 1..._. �....( .inch water service pipe <br />L.ir-�C _c.....�i=•...� CL� 1'���...... <br />�. . . .. ... ...... <br />On ........ f."� `-z � � r�rt-. _ i <br />�'`�- � ...,'�_.........:'r ..........�..... �. "�... Street <br />Lot.... .......:���+':;L?.......... Block No..:.' ......................-�--- - <br />�ddition ...... : ' , <br />�:.s.'C.r�.....:;".x-73.: �� °'� °- ...................................... <br />Remarks (..—._is. �c �j ,(.--, � <br />..... - - ........... <br />8uperintendent <br />LABO:;: ATD bi�'PG3IAL USED <br />_ No. � Size � — --- <br />Lead �onn�:ctior. Comnlete <br />Saddlr. Complete <br />..... _ _ ........................ ..-........... _.. <br />Servicc Cock <br />Service Box <br />� <br />No. Hom�s Labor ........................ _......._ _......Cost................................_ ............... <br />Cat in......._...........FavemonL ..................X........................ <br />........................Sq. Ft. <br />....................X........................ ,� <br />........................ <br />....................X........................ �, <br />........................ <br />....................X........................ �� <br />........................ <br />Total ........................Sq. FY. <br />— --------- --- <br />_ --- <br />Remarks..................................--................__......... - <br />Order Received..... <br />\Vork Campleted.. <br />......... . .......... <br />Foreman <br />