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�3,��� ` `'� ���� <br />w. o. ronw a <br />CITY OF �VERETT--Water Dept. <br />Application No..:�':T�...r:...... Daee......_:'::...s.�:...c.'.%............_1�J:::..1 <br />/- /'— Y � <br />Tnstall......-._-��y�-�....-..inch water service pipe <br />7` . . ... <br />��i: .it.t <�:......Tl.-.:Z.�t.:E.'. :S r::: cs.:.._ ............................ . . .. <br />For ........... ............ ' <br />�� �� �/`...:.....�1 F�+�,: t.i:.. /` %� ..............----....... Street <br />On......................... .. <br />Lot.............................................................. Block No....---...............-•--�--........ <br />Acidition ................................................:...................................................... <br />i � 3. <br />, , <br />Cr�� ,--��......... _<�.�:�.�....� :.:::� + �/...._--- <br />.....�.. <br />Remarks ............:..�'-� � � / <br />...................... ..... <br />........................ • �--..................................... .� <br />t� .j� <br />......... .... <br />............................................. .......................................�. `'. <br />LABOk AND h7ATERIAL USED <br />Lcad Connection Cemplete <br />Saddl� ComP�ete <br />................................................... <br />Scrvice Cock <br />Secvice Box <br />.......................... <br />No. iiovrs Labor ............................ <br />Cut in ....................Pavem�nt........ <br />....................x........................ ........................ <br />Total ........................59. Ft. <br />------ ---T-----"---- <br />Remarks ........................ <br />...'._' .............................................................................. <br />..................:.:..............................:.... <br />.......................... _....... ....... <br />OrderReceived ......................................................................... ................. <br />.:..... _ ........................... <br />Nork Cmnpleted ................................................_... Foreman <br />