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.--83 8 4' __ ��� y . � <br />�� �s <br />W. O. fO�M � <br />CITY OF EVERETT--Water Dept. <br />G�/ �- <br />Application No..D..3..�..7." �`�' �........19�.y <br />.. Date ......... . .................... <br />For <br />On <br />P <br />.inch water service pipe <br />Street <br />Lot.................................••--............._.....�... Block No....._......_..._................._ <br />Addition......... ....................................�.j ...... . .. .... <br />Remnr]• � ��"� <br />.....--- <br />s...... .. ....� .. ...-f.ltl.�..._....._.----..._. _.....__.._....�:.:.. <br />` ' .i . - <br />..... : t: ° �:r..�L...... ._�...........L�......3� �—�..�.�:.�.:G..s..� <br />� .........................._#..._...................- -•- <br />. . ........ ......................... �....._......_.._... <br />LASOR AND MATER[AL IIBSD <br />:,ead Connection Complete <br />Sad[}le Complete <br />� e / <br />`....f[(,�.........� Se:viceCock <br />:..._M .................... Se:vic_ Box <br />No. Hourx Labor ..............................................c:osc......................_.._....................... <br />Cutin ....................Pavement...................R........................ ..................._...Sq. Ft. <br />� , . . <br />,, �.,... !. .' ....................X........................ ......._............... �. <br />�� ....................X........................ ......._............... �� <br />��, . ,.... � ...................X........................ ........................ " <br />-�� Total ........................Sq. Ft. <br />Yr. , �, : .. ... <br />... .....................................L........�........4.t...:...:�..:........t...a.......�........................... <br />� � ♦ � �.. . ..___ , . .....�..�...... <br />_ ` . , �,:� ......................� <br />Order Received .................... .................................. <br />\Vork Completed.:......_�...x::...s ...................:. .....'.�iii�� C.... <br />.. ...... ......... .. ..... .. <br />Foteman <br />