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W—w.6. 'term3 6.40 `3/ <br />Priebe J - •- <br />CITY OF EVERETT--Water Dept. <br />Application No.�`Date.__Jf._ _..�.1�___19u <br />Install._______ inch water service pipe <br />For '� li--....t 1:1_l%'z� -----• ----- <br />On..................................... Street <br />Lot. �® •..-----•-••-• Block No.._SS _.... <br />Addition ........... <br />Remarks <br />f ?_` <br />iJ _ Sace�mendent <br />LABOR AND MATERIAL USED <br />_______________ _______________ Lead Connection Complete <br />Saddle Complete <br />1.It __._._! 6 r'P' ______________pipe <br />...... -•'-'•'-... -• ___ Service Cot <br />..... --- -••`s•----• service Box <br />J <br />�_ •- ._ — <br />..---)........ ----- •----••---..__....--•- <br />{- ._._. <br />ro <br />---------- .............___•I...... <br />.- • �••-••_.�___••••-•••--••--•-._...._.._......••-•-- <br />No. Hours Labor______________________ Cost _____-_____.__.______--__________._ <br />Cut in ------------ Pavement ............ X...... _....... ---------------Sq. Ft. <br />Total ............... Sq. Fr. <br />Remarks-------------- ---------------------------------------- <br />Order Received --------------------------- --------------------- <br />Work Completed -------------------- — - — ---------------------- <br />Poremxa <br />