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S.�.Priaha�M,_�b1���3 �'� : <br /> W.D.Form) <br /> � C;ITY' CF EVERETT�Water Dept. <br /> Application No..��-.`�.:�...(.. Date.......-.................�1 '�..r�.. . --�. <br /> � ) .. .. . ..19:.... <br /> �Install.... .. . ;.�✓.�........inch water service pipe <br /> , ,,�. <br /> Fur ",..�'�..... . � ' .1.:Sc11r:.:..:.:�....1. <br /> ....................... <br /> --' .............'--'--.... <br /> ... <br /> • k � � �� <br /> ..� �r_� .' ;. �� � <br /> On ........................L........_....4`.r.f..!.:::.........C'..._:.:.::::.!..:_..�.�........ Street <br /> Lot.............................................................. Block No..................................... <br /> Addition .............. .......................................::..... <br /> ........................................... <br /> Remar};s ........._�::'.!.�..:!..`..:.-:'....k,'1_.:::..:.:.........:...:.._.:::----........... <br /> ............ ............................................. . .. <br /> ....................~..... ...................... �.............��.........._..............---....---........... <br /> _............. ...... n,.��. � <br /> . ..1.:.. �.� <br /> ,.. ......- - -.-- .--.�....................... , <br /> �� . � .....'...:;---.... <br /> ......... ..... . . .. �° "..",,....�.1..�:...I...---..............-----� .�.,�.�.�.-:...._''..:::J <br /> ( v'0/1/ '`'... � . Su rintendent� " { <br /> ����, � J / <br /> ' "— � ' <br /> '���O., _; �Olt AND MATER)AL IISED <br /> ------� _.��, j=�— . <br /> ........._N�..............-.-•�...—..�� Lcad Connection Complete <br /> ......)..�..........._............... . ..............I SaGddle Co plete <br /> ....r.f.Cl........St..........:,�f[........ .G��aL...........................................Pipc . <br /> ._................................. ................ ::^rvice Cock . . <br /> ...................................................... Sc:•vice Hox <br /> No. Aours L:�Uoc..._..............................__......Cost................................................_-- <br /> Cu: in_..............._.Pavem_nt....................7i........................ ........................Sq.Ft. <br /> ..........__......X........................ „ <br /> ........................ <br /> .__._..__......t'......._............... .. <br /> ..................-.... <br /> ....................X.................... ... �� <br /> ........................ <br /> ---- Tolal ..._............... Sq.Ft. <br /> — --—-- <br /> - --- — <br /> Remr.rts............................... ........................................ <br /> . ........................... <br /> ....... _.. _..._ _....................................... ...... ................. <br /> ............................... / <br /> ............................................ ......................................................................... <br /> Urder8eceit�ed_.._............................................................ ... ...... <br /> .. .. . ......... <br /> 1��-�k Cim} lcted.f le' -..�% �i-��i;-.�: •..i�=., <br /> � , -........ ....... ........._ ...... .................. ..........._. _. <br /> Foreman <br /> � <br />