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R y. MI[�� 2 � �. - <br /> W. O��IDI14� A � � � � <br /> CITY OF EVERETT--Water 1�ept. <br /> Application No/�PSi/... Date............. .�.�.-�`� ....18�.% <br /> ..... ............_. <br /> Install..............�_::.........inch water service pipa <br /> fior ...............r.��:c�2rc.�u ✓J�� - <br /> ..........................................................._.._. <br /> On .........../...�i�....,1?eu�<....-?`.r`....-. ....�.�...::*x.tf...S��... Street <br /> Lot............................................._......_....... Block No........_..._._......_._. <br /> Addition <br /> .......................................................................................................... <br /> Remarks ..��'i:.4.�F..4.....!�,-_.....`.:�--..:...�.�..�.�,�-�..._-..�_.. <br /> ..........................................�.?..�C..----...................................................._............ <br /> ..._.._... <br /> ......� .N..�...�1��.¢�......._......................................................._......._.. <br /> __.. <br /> ..... :......_.............:.:........ � ..... <br /> .....IitfiI...2 �,.'`�, �b°.�...................._.................................._.........._._... <br /> . ................................................... .. <br /> � <br /> . :�.'..�...._. .. <br /> 4t�j� r.YAFt�i� ..Supertntend t <br /> ���,ry llpC... � c:cl <br /> LAB06 ANiD MATERIAL QgED <br /> No. Size <br /> ...................................................... Lead Connection Complete <br /> ..............._..... ............. Saddle Com le <br /> . / rr........... ....................._P te <br /> .........�..7....2t....�..�............... ...............................................Pipe <br /> ...................�.......... ................... Setvice Cock <br /> ...................................................... Servlce Bo: <br /> No. Hours Labor..........................._.................Coet.........................._....................... <br /> Cutin....................Pavement....................R....................... ........................Sq.Ft. <br /> 1� <br /> i ��, . ....................�....................... ......._............... ., <br /> h ,� ...................x........................ ......._......... .. <br /> � ...... <br /> �-i _ ..................x........................ ....................... u <br /> ro�i ........................sq.Fe. <br /> Remarks...................... . .St ./l�.a...-:;�cx..L,..�.,,..................................... <br /> ...............................................�.�.._..:J.6S:1....r.C..GS4:�'.....:t.i...A:t:.:.................... <br /> •., <br /> .................................................:e.:::t.1.1�.:4.........................................._........... <br /> OrderReceived.............................................................�......;;.;.,.. ................. <br /> �Vork Completed.t-�..::...1,....:...,�...�...................:...1..�_�%.::�'...:....... <br /> Foreman j <br />