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d <br /> - � f'�' �j .� ( - _, /y�6 ;3/f <br /> w. n. ronrn o <br /> CITY vF EVERETT--Wat,er L7ept. <br /> cr-t-cG. /� '� � <br /> Apz,liea�n No.. r�.._........_---. Date.......:........=.....l�o� .................19...... <br /> lnscal'....... .................._:inch water service pipe <br /> i <br /> rx ..... ... ...2-�.�:c>.....�:/:Z.<'z:2r�............. ........................... <br /> On ._.......�:� ?'.."d.:........��...�'..1:L.11..��,� . Stree! <br /> . ................... <br /> Lot.............................................................. Block No............................. ..... <br /> :?dclition ......................._................................................................................. � <br /> .... <br /> Remarks ........._................... . ........... .................................................. <br /> _................................................._......--........._..................._........................._ <br /> _.....--............................._.... -......--.........................................----............. <br /> .................................... ................................................................................ <br /> ...................._........................- ...... ............................. -._....................... <br /> Superintendent <br /> LABOR AND MATERIAL USF.D <br /> --No__� Size I _ . .------- <br /> ....._............._......................._.......I Lcad Connection ComPletc <br /> ........_..............................._........... Saddle Complete <br /> ........_.............ft.l........................... .................................................._. ..__ _.. ... Pr,:> <br /> ..................................................... Scrvicc Cock <br /> ....._............._............_.........__..... Service Box <br /> No. Aou;:; Labor_............................................Cost......._........_............__..._......._... <br /> Cutin....................Pnvemmt........._.........X..................._... ........_............_:;G.7�t. <br /> ....................X....................... ......._............... ,� <br /> ....................X......._.............. ....................... .� <br /> ....................X........................ ,� <br /> Total .......................Sq.Ft. <br /> ---- --- <br /> ----_— <br /> Remarks............._............................................................ .........._...............__. <br /> ................................................................................................................... <br /> ........................................................................................... ..... ................... ' <br /> OrderReceit�ed.................................................... ...................................... � <br /> �Vork Campl�ted......................._.............. ......._...._......_.......................... ._ <br /> Foreman <br /> , —� <br /> r-a•.•i..' <br /> .. '�..�s.�:.�� . ,. <br />