Laserfiche WebLink
/ 5` � S'� � � -- , <br />�-�. <br />W R fORM 1 �I/ <br />CITY OF EVERETT--Water Dept. <br />- - � �- <br />Application No../..:�.::�..�..�� Date...........'Y.. � ........................19�;_'. <br />� 7�sta11�._`.1....J. "....�.. 'nch water service pipe <br />. <br />For ....,...t�.,:e..:�:.........._..x.?:'.lr.Z.:.C.:Y.-i.:_.._......... .._ ..................._-..... <br />rr�' � �%:�� lt.;.:�::az .:.:................................ Street <br />On ....:.:..._/. �... ....... � <br />r��� <br />Lot.............................................................. BIock No................._................... <br />.'ldditior. ....... - ..... - ......._:....- ................_ ,........................................... <br />-% <br />Remarks �:�i,�::.:. -�-r.._:>...:G��-.,..� .:........................ <br />i <br />....................... ._........ <br />_ ......_ ......................... ....... <br />.................................................. ....................... <br />>;- C 6 _� <br /><:' X ....................C.[.........."......................_.............................__........ ....."'.. <br />//� �'r� -i-a <br />.......... ... ....................... v �.......................'"'............""""..................'"".... ........ <br />SuPerintendent <br />LABOR AND MATERIAL USED <br />_ No.�_ Size <br />............._..._I Lcad Connection Complete <br />....................�� Saddle ComPlcte <br />..... Scrvice Cock <br />.................. ............. <br />..................................... Service Box <br />No. Hours L�bor .............._..---�---..................Cost................................................... <br />Cut in....._......._....Pavemcnt_ ..................X........................ <br />........................Sq. Ft. <br />...................X........................ �� <br />........................ <br />....................X........................ �� <br />........................ <br />_._........_Ji ........................ ,. <br />....... <br />Total ........................Sq. Ft. <br />--- ------------------- <br />Remarks ....................... --- ._...... -....- - _ _ _ <br />...................... ............................................. ............. .............................. t <br />OrderReceiced_ ......................................._.._................................................ <br />i,Vark Completed ..........._......__ ............................................................._.. <br />Foreman <br />