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_ . _ .� � a 9 9 . ,�� :a- <br /> w. o, ro�w a <br /> CITY OF EVERETT--Water Dept. <br /> �� <br /> A�plication N�%?_.r.%.,l..J Date..%t7..:��...1�....�:.........19.� 3 <br /> Tnstall........��..�:...�....-,.inch w_a�te_r__s_ervice pipe <br /> For �'��.�::.._��cs.�:S�szr�........!/4.:c?r�.....1�.��:�...�............. <br /> On ......................�.../.�..'.'..�C��?:f.l.:�.7.[s�:f:-:.�?:��............... Street <br /> Lot..........a_�.......y..................-------...... Block No.......---.........._.... .--�- <br /> �ddition ..�.�..1:,�4...�7_.....LLt.C..E�_(,:L`�[..�:r.x:...._�-....i.L..._�' <br /> Rem:.rks .L��c�.c.tL.rc-,E� ..;. . �.is.trr.r.c�?-=-....... .......... <br /> ^ � / � ..�._ � <br /> .. <br /> _...... .... I..:�."-.�c t� �Yi.:�-f--�:................._....._...........................-- <br /> - ...................... <br /> .......................................... �t.._.-��.u�1�................---................................... <br /> � ',.�w......�.'.�...:'..... 3.�.... ---.. .. <br /> ........................ <br /> - ' . ........t�... �..........._l.........""'...� <br /> ......`,,.....__.....��':�.`:.`_.... . . .._�;,f....�.:c':.Lt-�-_...�.......��'�-�-� <br /> ., � ��i erinte ent <br /> �=-i / �: ��7� �7r1�/ <br /> LABOR AND MATERIAL SED <br /> No. Size <br /> .... ............................................ Lcad Connection Complete <br /> ...................................................... Snddle Camplete <br /> ........._...........St......_�.:,(.....�........ ......:Y.:.:..:.:.'...:::.:✓:........................................PiPe <br /> ..................................................... 5ervice Cock <br /> ...................................................... Service Box <br /> ...................................................... ................................................................................................................ <br /> ........................... ..........................I ................................................................................................................. <br /> No. Aours Labor............................'---..............Cost.................................................... <br /> Cutin....................Pavement....................X........................ ........................S9.Ft. <br /> ....................X........................ �� <br /> ......._............... <br /> ....................X........................ �� <br /> ........................ <br /> ...................X........................ �, <br /> ....................... <br /> Total ........................Sq.Ft. <br /> ------- <br /> Remarks............................................................................................................ <br /> .................:.......................................:................................................................ <br /> ............................................................................................................................. <br /> OrderReceived................................................................................................ <br /> �Vork CompletedL.:.i...:: '..:'..::r'...i.:........::......i. -L , <br /> ......._. ....................._:..:... � :_ <br /> Foreman <br />