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•r H.•J. PRI[BC� 3 � � 3 • `l � :��� <br />w. p. l�RM ] <br />CITY OF EVERETT--Water Dept. <br />� .. <br />Application No...._..z..:t..' .;;. vDate.........T1C(:..v......l.,oT ................19...... <br />� Iastall ........................../.... .inch water service pipe <br />For .._.C.�1,�� 1�1``(:. :�...._!-..—�.�.!'..�--f.`�:C_2:.2,1��....... <br />'�,z',..�r�........��i.�c�..��'%./.��lz�>, scr�ot <br />On ................ . . .. <br />Lot.............................................................. Block No........ J...............-�---... <br />Addition �� � � <br />..... -�...Z_Z. �....!�'..J:Y.:t::::.:u::r..t..t:.<_:....:_ ..Yj .......................... <br />Remarks <br />ttendent <br />LABOR AND MATERIAL USED <br />No. i Size I <br />Lead Connection Complete <br />Snddle Complete <br />.... . ....................... <br />. Scrvicc Cock <br />.... Scr�ice Box <br />No. How�s Labor ..............................................Cost.................................................... <br />Cutin ....................Pavemcnt....................X......._......_....... ........................Sq. Ft. <br />. .X ........................ .... <br />.................... <br />�%%Zcc..� �%C /-.So2�......._..........x ........................ ....................... .. <br />Total .......................Sq. Ft. <br />------- ---- <br />Remarks ............................................................................................................. <br />Ho�se o>, r�t W�9/ <br />..................................... � �........................................................................ <br />�'� c e'h a W- S/ <br />........................................................................................................... � ............ <br />OrderRecei��ed ............................................................................... <br />\Vork Completed ................................................................................... ..._. <br />