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:i4,' <br />��;jr <br />� /�t�s9� - � <br />w. o. rewrn a —�'/ N., <br />CITY OF EVERET�'--Water Dept. <br />Application No...l�� i1 �::.. Date..._�.::....-" l � <br />... ........................... 19. �:..'i <br />Install .............................. .inch water service pipe <br />For..................................................�----............................................................. <br />o„ ..._.�L�,.�:.. �%:s.:�:�^---� =�`. <br />....................................................... Street <br />Lot.............................................................. Bl.ock No.................-----............... <br />Ac�.dition ......................................................................................................... <br />Remarks............................- - - -- - --- _ <br />Superintendent <br />' LABOR AND MATERIAL USED <br />No. I Size I <br />:.ead Connection Complcte <br />Saddle CornPlete <br />Scrvice Cocic <br />Service Box <br />No. Hours Labor ..............................................Cost................................................... <br />Cutin ....................Pavement....................X........................ ........................Sq. Ft. <br />....................X........................ ......._............... .< <br />....................X........................ „ <br />........................ <br />....................X........................ �� <br />Total ........................Sq. Ft. <br />Order Recei��ed ............................................. <br />\Vork Completed ........................................... <br />/ <br />�Foreman �� / <br />