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i�:i'nenc u � � ��� � <br /> w. o. voew� �� ' ' - <br /> CITY C�F E ERETT--Water Dept. <br /> Application No..��:�^�.�Y... Dat ..........._............:���.1.......19�...�/ <br /> Install..._.._��...._.inch wa r service pipe <br /> For .............._�a %A.a.�S�..�. �.:.4�^:.'.�al............_......................_. <br /> On ..._............�...,1._��-_....._.... ... ...... . .. Street <br /> ........................_.. /. <br /> Lot..................�..7.`.�_.f._��..._......_.._... Alock No........��._...Y..--••-•...... <br /> Addition .............................................. ... . ......_....................._. <br /> �/� i <br /> ----........._. . <br /> Rnmarks ..........�..4S.s..:L1-�....... _. ...�:C.h...t.._..»................. <br /> ............................................._.....i. .....--•....._-----................._.._.............._... <br /> .... J <br /> ....... .....K..._'" '"LJ."��.L.................................................................._... <br /> . ...."' <br /> ; '�1 � '_ � <br /> 1 <br /> --:..–;:•;4-�'a.... :�... . ....... • <br /> ............._................................ . �� <br /> .:_l'...:�::. �.:'..:... ......aS....-�----....................................��.:���..�.4�� <br /> i <, �- ,��Y' `'� Su intend�t <br /> ` ` ' n �, ) <br /> � <br /> • ` :.� �.eao�s erro atw�er,w uaxn � <br /> No_ Size � __ <br /> ........................ ........................... Lead Connectio¢Complete <br /> ..................._......_........................ Saddle Completc <br /> ......................1R..................._..... ..............................._......_.._...........................Pipe . <br /> ..................................................... Service Cock <br /> .................._.................................. Service Box <br /> No. Hours Labor..............................................Coet..._.........._.........._...............---..... <br /> Cutin....................Pevement....................X..._.._............... ........................Sq.Ft. <br /> ....................X..........._.._.._... ., <br /> ......._.._........... <br /> .X....................... .� <br /> .................. ........................ <br /> ....................X....................... .� <br /> _... <br /> Tota] ....-•--...............Sq.Ft. <br /> — –� � .; ---- � . . <br /> Remarks...;�.......................................:.....:.:...:.................................:.....:...:... <br /> ........................................:..............•-�--�--........................................:....._........... <br /> ............................................................._....................................:............ .----........ <br /> OrderP.eceived.............................................................:............................ .. <br /> �Vor}_ Campleted........................................................:.:.............._.............. <br /> Foreman <br />