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<br />CITY OF EVERETT--Water Dept.
<br />Application No.�..��..:.'...:.::..'.: Date .............�:`�f�(:,...............t91,�
<br />I�stall.........,��.....-.-..ic.:;: water service pipe
<br />For..................................................................................................................�
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<br />�,'�.��^ ,� , ti tY /`::'.ti...... �� --........----..... Street
<br />On ...........- ......... .....--... .,...c...s.............
<br />T.nt - - --- --�--...-- ------------... Block No .....................................
<br />Ad�lition ..........................................................................................................
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<br />, Remarks .... �_�::I..':6:-..<.::,:..1..!-=- ......................................._---..................--
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<br />�,.... � . r =,i � . _-r� �'---=��----': :'-............�:4 :f�...._�.....,�?- a3s
<br />No.
<br />LABOR AND MATGRIAL USED
<br />.............
<br />I Lead Conncetion Complete
<br />............. Saddle Complele . -�
<br />._, ,,
<br />..__....... ,�. l,� .,.c._..... � �._. .�I ........................Pipe
<br />�,..... _,. T......
<br />.
<br />............. $�rvice Cock
<br />...:......... Scrvicc Box
<br />No. I-Iours Labor ............................................. i:osc....................................................
<br />Cutin ....................Pavetticnt....................X........................ ........................Sq. Ft.
<br />....................X........................ ........................
<br />�,
<br />....................X........................ ��
<br />Total ........................Sq. Ft.
<br />---- - --- .. — —_
<br />_ � i �:
<br />,
<br />Remark:,.. ,�,... �1,�.�./.-�:..... .i�%....._r...£.,c,....;..� .......................................
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<br />: .:>..........� :..�:.:....i,.........,,.�..::..:::Y/�� ..................................
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<br />�;_...,:,�l.�;;i.f........_:.:�.,1�,/.1�.....,,,:..,.,.-� ..� ................_�---.._......
<br />OrderReceived ....................�.y......./...................�._%....:........................................
<br />\Vark Cempleted.�L�:.:.:.L.1...`.Cc...1.....�t:,�i:;;:ftG.L:�G'i::�«.
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