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ia�8� ^ , <br />_ -�_ CJ.> � . <br />Y.`. o. rvaa a _ ' - • - <br />CITY OF EVERETi'--Water Dept. <br />Application No._/'L^"�ti:..... Date.......-.�..-.�...�:.`..%.._.._.._......19...... <br />Sastall...........__ ............... .inch water service pipe <br />For.............. - ................--..............-----•• ................................._........---.... <br />� � � <br />On ........7.L.4'....{._.....i: �_'� t..=-:K:...�t.. ��: f.'-�--�..:.---� <br />...... Street <br />Lot.............................................................. Blocic T�io................----................. <br />Addition- .........................---.....................-�- ..............................._....... <br />Remarks � ..... - .......................................---... .......... <br />� l -�ti.� ............... ............... <br />. <br />/..................................... ..... <br />. ....----...'�..�:1.. � ::......................."-"'--""'.............---'. <br />No. <br />._...---............_ ..................�.._..!�%`I:�� : z: }:.;� <br />LABOR AND MATERIAL USED <br />Size I <br />�:.ead Connection Complete <br />..................' Saddle ComPlete <br />.............. .. .... .... .. . .... .......... ........... <br />.................. Service Cock <br />.................. Servicc Box <br />.......................... ....--�-----� <br />No. Aours Labor ..............................................Cost.................................................... <br />Cutm ....................Pavement....................7i........................ ........................59. Ft. <br />....................X........................ ........................ <br />,� <br />....................X........................ ........................ <br />„ <br />....................X........................ �� <br />Toln: ..................._ Sq.Ft. <br />— — — - <br />Remarks..................................................................................................... ....... <br />................................................... �--.............................................................. <br />..................................................�--........................................................................ <br />OrderReceived .................................._................ - ................. - � --.............. <br />�Vork Cocnpleted ............................................................................................ <br />Foreman <br />