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�W. D. Form 3 isoo a-i-i � c. r. � '�' <br />CITY OF EVERETT�=��'ater Dept. <br />Application Nu._%��-�-- Date_5,7---------1912'� <br />Instxll __ ���-__inch ��•ater service pipc <br />-- <br />ro,•_%�Z�,_. __�-�__/��'---- •--- --- -- - — ---- <br />On-- ---�-�-:��1---��--- ----'�— ----Street <br />Lot ------------ -------- lock No.-------- �-- ---- --- <br />Addition---------- -- -- ----------__ �--------- <br />Remarks--- -- - -------------------------------- - <br />— - ----------- -- ��!/1 p � � <br />--- ------------- ------_ - . . <br />'j' "__�_�"�_`-_'� _ V 4 . J1.li <br />Y� . � <br />LABOR AA'I) hi•A'CrRIAL U3EU <br />512E <br />�. �—'_ Lrad Cunncction Cnmplcte? ��%t-�'�-� <br />�ii2"._ S:��idle�CumPlcic <br />1 _. A.%✓: ..___._.Yipc <br />�ti __ <br />_. _______.___ <br />_ _ .�_ _ _ . _ _ _ . I Se �eitt Cnck <br />�.fn.c� Srrvicc Box <br />— ' -- -. I - ' .-- --'-----' - --- -- -- '-- -- -- --- --- '-'-----' <br />--- <br />No. Hours I.abor____ iz..__"_._._.__- _Cost___.�•-3�____""___""__"'__" <br />Cutsin.__. -. __.1'aremvnt .-__.._X_______ ______ ____'__._Sq.Ft. <br />� . __.___..\____'_.______ •• <br />_________'.. <br />.._ ._..X_..__..___ _______"_ <br />.. <br />_.�..___.___ .� <br />'_ 'f�aal. '_____'Sq.Ft. <br />-----_— <br />------ -- <br />Henu+rks__:;s�tcrial_5!ip_;to._.2935�_5.1a_:__•-- -- <br />-------------------- - -- --- -- ----- ----...------- <br />- -- ----- <br />Order I{eceived ---------- --- ---- -------- <br />�Vorlc Complet�d _�_-��{�u'n�-�;;� .-------------- <br />�t Pnreman <br />