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W.D.FOqM3�����• � � p <br />Acct. I�o.:rS..�� :3c1 J...... <br />r�� <br />CITY OF EVERETT—Water Dept. <br />Application No...L.l `1.'f l ...... Date.----- .:-� .- �- -L:.�....- ---- ..19......-- <br />Install ..................._..._....... inch water service pipe <br />Addrnss....- --....._...�_2 <br />Lot....... ...............--�- -..... <br />Block <br />Contractor ................................................ ........ .. - <br />Re m a r ks. -- ..................................................... ............. <br />� .............--'•/'C/{_�-----...----........_....----......----.. _--�--- <br />....... Rec. No ........... ........ ....._..........------ �-/-•-......-- -- <br />BY.................------�---....--•--- _-•-7.� . �%:�:..�`�:1:? ::1.:Li¢. <br />8uperinlendent /'� <br />ZG� � <br />Shop Remarks ........... ..................... <br />�1'orlc Completed............ --� - ................. - ... ..... - ............ <br />........... � - <br />Foreman <br />