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/8/2� �y� `"° cx� <br />N'. J �FO^M 9 � � <br />Acct. Nn... ..._.::� ...... .......... <br />CITY QF EYERfTT--Wa�er Dept. <br />Application ATo....�.��Lt�:.G::.._.... Date....��L?.�`::'.... � ..�'..�........19........ <br />7nsta1l ................................ inch water ser��ice pipe <br />Owner ............................................ . ._... -� --............ ...... <br />. <br />. .............................._..... <br />;y,� , /��� �c'�� � �U � <br />Address ............. /._1....i.Q..................... ................ .........................................-------��--� <br />T.,,r - = -...Block No........_.......---• .......................... <br />Addition ................................................... <br />Contractor ............................................... <br />it....--- ....................-------_... Rec. No.....-----...................-----.......----................... <br />� <br />By..........................._...............---_._.`.�a.------ ......-:..'_.�� <br />Superintendent <br />. � '. <br />......._.""'s..: t:...-'.t"'- :t......... <br />Shop Remarks ...................._ <br />....... .................- <br />....................................... <br />......................................... <br />�\'m•k Completed....... <br />- _ _ ......... ..... . <br />Forema� <br />� <br />