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2111 JACKSON AVE B 2016-01-01 MF Import
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2111 JACKSON AVE B 2016-01-01 MF Import
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Last modified
2/19/2017 5:09:28 PM
Creation date
2/19/2017 5:09:27 PM
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Template:
Address Document
Street Name
JACKSON AVE
Street Number
2111
Unit
B
Imported From Microfiche
Yes
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�'"l � 3 � � <br /> ;,,: <br /> w. u. roa�� � � <br /> CITY OF EVERETT--Water Dept. <br /> , i. ...i Date.............:�........:'........ ..._..._19...:;.' , <br /> Application No..:.:..:...:...� <br /> Tnstall:.._........................,:inch water service pine <br /> � � j � <br /> , � <br /> �. ............:.....:.........................................._. <br /> For .....:r.._:..:.:..._.....i..:...e`......._..._.. <br /> On . ..........:..::.�.,:........... <br /> ...........:%._:....._..::�................................. Street <br /> Lot.............................................................. Block No..................................... <br /> :�ddition ..:................................. <br /> ..._......._..................... <br /> I:emarks ....... ; ; .......:,..:.:..::....:..:........_..................... <br /> ......................'...;....... <br /> ................................................................................................... , , <br /> ....................__....._..........._......._.........__..................................... <br /> ................................................................................. ..................... <br /> . .....................................................................SuPerinlendent <br /> ..._..._._............ <br /> — --- i <br /> LAISOR AND 11iATER7AL USl'sD _ <br /> —. . .. ' Size I — <br /> _�— --_ <br /> � r Laad Connection CmnP�ete <br /> .....................................................I <br /> . iiaddlc Complcic <br /> ......................_......._..._......_...... ..._._PiPc <br /> ft........_..... ._.. ___.. _........................_........._.... <br /> ..._....._ . <br /> ....................... � <br /> . ......... . ...__..... Scrvicc C'ocic <br /> ........................... <br /> ...................� Se:vicc I3ox <br /> �...�...��...�.�.........�.. .._......_...........I .�...�.............�_�........��......�.......�..�................_.........�...�._._.........._.._........._ <br /> ........................... .... <br /> .................................................. <br /> ........ ..........................Cost.................................................... <br /> No. Hou��s L�bor....... . ... � <br /> Cutin....................Favemenl....................X........................ ........................Sq.Ft. <br /> ...................X.................... . ........................ <br /> �� <br /> ....................X........................ <br /> ........................ „ <br /> ....................X........................ <br /> ........................ �� <br /> Total ........................Sq.Ft. <br /> , __----- <br /> ,Remarks.... ........�................................... ........_..............................._...... . . <br /> r ,, �. � . -.:�.�. ....�.-.�_�.-.��..�............ ..... .... .. ... ..........._....... <br /> .. ........ . ..... ............... ............. ....... .............. <br /> Orderfteceived..._......._...._...... ....._................................ ._......._..._..._....... � <br /> _...._ ..__..... _ _. � <br /> Work Cumpleted...___._........................_........_...._.... Fareman <br />
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