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w. o. ronM� I ` �` �� . ✓ v f/ <br />CiTY OF EVERE7T--'�(Iater Dept. <br />%`/' '�-� �� — <br />� �-- � � -- .� .- (-,, <br />Application No._ ....... ......... .... _Date...._r�....-::.......::-._:. �.........19.....: . ' <br />1 � <br />, , 1��ta11....... ,:: :=' ............... .inch �vater service pipe <br />�/� �>�- � <br />I'or "C...:R'�i�.ct....._`.�l:�.�::_�....5 ::.:................................. <br />.....��... <br />..._..... <br />On .....�...'..'`j�.:...., ..............::r�' ` y_ .'�.L=1--�..... Street <br />r. .........._: ::....... . ....... <br />Lot.���C3— Lrcri<.�r� � l r" --. ( � <br />.............................................. B10C1[''i.'6''..__.:.......................... <br />nr{dition _ ...............::..�.._-..........................._.................__.............._....... <br />�_ � <br />Remarks ............1'/(::.i��=:;r_ :- — <br />__ .................................�.... . <br />. � ' � ..'n "'_ ................. <br />• i . .. <br />�� •%F._e.h - �.4.:...""'!. <br />_ ..................._..................... ., , <br />�...... _.. ..... _:. .. _...:. _.... <br />...... ..... <br />............................................................... � / � <br />, <br />f..:.............................. ......�C L <br />............................................... ....................._ . .. � ....__s.:.......... ' ....... . �. ... <br />__.........._ ....................... S f ! <br />_ ....... ...... ...._ y..��..�.._ ��....� <br />��////,,, . ..._...... <br />— p/ l� ,� Sup rintendent <br />� � <br />Na. <br />_..._...Z.L . <br />I.A(iOR AND hfATE21AL USF.D <br />................__..� Lead Cnnnection Complet�: <br />.................... Saddle Complete <br />::t.:.::..r._........I ..i.,:LL.:� :,r,:_ :..:.......................__...................Pipe <br />-_ ......_ Scrvicc Cock <br />....... ... <br />..................... Scr�ice Box <br />� <br />No. Hours LaUor .............. <br />Cut in....... _..........Pavem� <br />....................X.... ................... <br />............ .......X.........._ _......--- <br />.. .................X... ........ <br />.... ............. <br />......Sq. Pt. <br />............ ........................ „ <br />Total .. ...... ............Sq. Ft. <br />'—_—_ _.___ _ _—_____-� _-_ --:-- <br />Reina rks ....................................................... .. ........................ <br />....................... <br />....._ ....... .....................:......... ..................................................................... <br />G <br />................................... i.:..:....................................................................... .... <br />Ordergeccived ............................................................,...,.........................� <br />\Vm•k Cempleted..'�.:.:-;....:_ :...............................�._. � :.. <br />f ........... . ............ <br />N'arema� <br />