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5.a M.M.M,.�ni/"VV �V <br /> W.D.Poem] � <br /> CITY OF EVER�TT'--Water Dept. <br /> Applicatiun No.....�_�._.fli.:.��.�� Dete!.....................7��...g....----..19.7...6 <br /> Install.........::::..:..�r.......inch water service pige <br /> , , � f�.� .._.� � �� <br /> For ...........�':�..:.... ti ��,�.,..:.__..., <br /> ........... ....................................�--.. <br /> ,-,--.. <br /> ............ .. <br /> On ............:�_.?�..1..: ---........�`�-��:::.':_'.:.:.:....................----........... Street <br /> Lot.............................................................. Block No..........--�------._...........-•-- <br /> Addi!ian ...............................�--..... <br /> . . . . <br /> ........................................,.................. <br /> Remarl� .....�J'.Lt..�L.�..._o,:.!...�:'::!!��.�..�,,,,....'-......a' �.'.:.'.� . . <br /> �rr--��`.--i_ _' , .. <br /> ... .........................�«... .1""'.............. .1...��::�:S.�;t, ../ �� <br /> . .,:�........... . �. . � <br /> ........:�........................................................._�..:l�<.._::.i_�...1..�..�/............�..-=--.. <br /> ....:/...........................���............................................:...... . <br /> ... . '._..... <br /> ,. ' .'i, / ( . r .•1 ' 'i�'--' <br /> . _ �«_a ..................�..�....r-��,..1..:�......................_............�..�..�...��-,-•.�_ <br /> �`��: �.� � ,y�� r� Superin dent <br /> ,','K+o f . ;� �" � L( <br /> ���• � ' �"' � L.1BOR AND MATERIAL IISBD <br /> No,-;r�.i ' Size � <br /> ..—��— ---- <br /> � '�� ...............� L.ead Connection Complete <br /> ....................................... <br /> ...................................................... Saddle Complete � <br /> .......................it............................ ........................................................................Pipe <br /> ............ .... ..........�............ Service Cock <br /> �( � C `- <br /> ...................................................... Scrvice Box <br /> .............. . .. ..................�...... ................................................................................................................ <br /> .........�.:..... ....'-....7._J....... .................................................................................. <br /> Vo. fiours -Labor..............................................Cost.................................................... <br /> Cutin....................Pavrment....................X........................ ........................Sq.Fl. <br /> ....................7......................... �� <br /> ........................ <br /> .................... '........................ ........................ <br /> .� <br /> ....................X........................ �, <br /> ........................ <br /> Total ........................Sq.Fl. <br /> ---_-------- �-------- -- <br /> fiema:lts...:.............::.....:...............:....._:..:........................................................ <br /> _....................._..........................:................................_............._.........------.... <br /> .........................................................:..............................._................................. <br /> Orderlicceived......................................................................._...................... <br /> �i'ork Completed..:::.:...:................'..,.................:...::........:.:.......................- I <br /> Foreman <br /> �� <br />