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/�28� - ' � � - <br /> W.D.FOqM 3 <br /> !� <br /> Acct. N�:�- ' <br /> ...................:........ <br /> '� CITY OF EVERETT—�yatar Dept. <br /> Application No.11.�?.F..1.... -. Date.....��.: .c.E<.--.�--............19.C.Y <br /> Install..........�..�,___,_.__..__ inch wa�ter ser' cvi'e pipey <br /> Owner............::�:r_........_ �y�`-':..�. <br /> ........... ... s................ <br /> _ y� ...................................... <br /> Address----..:3:J�Jl_/�-<.r:r� /�-!�:_ <br /> . . �.�................................................•-...........-- <br /> Lot........................40.....--..._..........__.....Block No..............................----.............. <br /> Addition..............`...:......•�---.............................----.........---..._......................_........._........ <br /> Contractor..._.1-c'i:�f....:a-��.-.;�:t.:::-..�.-.:.:. ./..��i o....l.✓.+�` <br /> . ............. <br /> Remarks......:2�.G�:�..:l:'.�s.,cwc:�....- �'`l�/ i " � �.._._. <br /> .............'---...t.....F'!:�._........ <br /> ......................_...._.........................-"-_"-.............._......----"---'-............. <br /> . ....---•---.....-'..............................--�- - .......... <br /> ....... <br /> �'�' ' --'.....................`-........ <br /> ��u:��:...... <br /> Amt.......�,s./J.......':--•............. Rec.No......... ... <br /> •- �- ............................. <br /> By-............._--....................... . n <br /> vr`=:-fC_-:z`jc............ <br /> Superintendr.nt <br /> "_.-'_"'.--_._.-.-.- <br /> �:� <br /> "-"'...�::...,....................................... ' <br /> _ ......................................"-.....'--.. <br /> -•--•--.�---.-...' .-=-•}��=?�.....................................................--........._................ <br /> ..:.:.:.:.::... ' <br /> . -- , ..._:. <br /> ...........:........�--.......................-�-�-�---�-..............................--�- ............ <br /> . . ............................................................................----.......---..-.-.......... <br /> ..,.............................................................�--.-...........................----......... <br /> ........................................................ <br /> .._.--��-�--�......................................... <br /> Shop Remarks............................................:. <br /> .......................•---�--�•--.......................... <br /> ......-�..........................---..................---------...........-----�-.................._.._. <br /> ....................................................................................................�--....-�----......... <br /> .....................���--.............................................................---..........---•�--�--....... <br /> .............................................................................�-�--......................-�---�-�-��--�- <br /> ...... ............................................................................................................. <br /> ..........................................................................�-�--........................---�--........ <br /> ............................ ................................................................................... <br /> ............................................................................................................................ <br /> ....... <br /> WorkCompleted...._.................._....._........._.................... <br /> ................. . <br /> . ............ <br /> Foreman <br />