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� ��3" � �" '� - ,, <br />w. o. r H / �r �� - <br />CIT`I OF EVERETT--Watzr Dept. <br />Applicaticn No...;....:. '....:'. . :. Date........__.�_....! _._ ....................19.._... <br />� Install ...............................inch water service pipe <br />/ / <br />For _..:_::.:.`_.:.:..r..%_:�.......r.:...._........-:-:<.`_.:.....::..._. <br />................ ... . . . . <br />. 1.,- . , <br />. . ...... <br />On ...........::::..i. .......:C:....:. � . � ' .. .... Street <br />, <br />..........� ::..... .......... _. �.__.....,'--�...:. :. <br />Lot.............................................................. Block i?o...................................._ <br />�ddition ............._-- ...................:................._ <br />.. - ........................... <br />Remar4s.......... ............._ .......i/%._._......::,.... � ,__ <br />............ .............................. �- ............................... - ..... . <br />Superin:eu�eat <br />L!!BOR AND 111ATER[AL USED <br />5�ze I <br />..__.__i Lcad Conn•ection Complete <br />_._. _! Saddle Comple:e <br />........... ... _...................... _........ _... _..... ..................... P i � c <br />.......... Service Cock <br />_........ Ser.ice Box <br />............................................ <br />No. Hours Labor ..........................._.................Cosl................._..........._....._........... <br />Cutia...........__...Pavement ....................X.._..._............... ........................Sq. Ft. <br />........_..........X ......................_ �� <br />.... .._...._.....-` <br />...................X................_..._. ,� <br />........................ <br />....................X........................ �� <br />........................ <br />Total ........................Sq. Ft. <br />--- ------ ------- -- - <br />P. e marks ...................................................................... ...................................... <br />............... . ........................................................................................... ......... <br />OrderReccived ..................._................._... __............................................. <br />\Vork Completed .................._......_.............._....__... __....................... / <br />Foreman <br />