Laserfiche WebLink
� <br /> 77•D Form�M���'T'yr/ I \r I . .. ' '_' - _'_ <br /> CITY OF EVERETT--�`�later Dept. <br /> , , -- � <br /> Application DIo...l.�..�I._:�.�. D�te....................:.:.: ....'.:'�.v....19._y� <br /> Install........:�=.�;.4:.........incU �6ater service pipe <br /> For .............: :...�:...�:....:..::......�.`.c:..1....`................................. ............... <br /> . ; <br /> , • : j � , . � Street <br /> On : � _ . . <br /> .................:........i.........,................:..................�:,._................... <br /> Lut................................ ............................. Block No...-�---�-•-�--.......---•--......... <br /> Addition ..............................................:......................................................... <br /> ' � , a . <br /> Remarks �"�., �_ � ... ._....t...----....... <br /> .........:.:................... ..........:.........:...............:......._ <br /> � : l <br /> . ............ . <br /> .-./. --_ r �-.....�......................... , ............:..... <br /> ...�. r �. ... <br /> ....................... ............ ............ :. ..�.r. . .._�..,..,.... ... . . . -�-�� <br /> ....... <br /> . ... ... <br /> , -, � �--- - - <br /> 2 �— c, — <br /> ........_... - .............�........_.................. .........................................------r-...._-- <br /> — , :. <br /> . -� ...... _Ji.`.:U....._........................................tS.-'---.:.....�.:...1- � �- <br /> � '���������-�`��-��� / Su erintendent -� <br /> ; � �a.. . ,,�' � p I � <br /> � , _ <br /> �� �� �LABOR AND hiATERIAL USED <br /> j�! �� 4Size � _ <br /> -- '�� ---- --— <br /> �� ........... ........... �� Lead Connection Comple:: <br /> ................._�.. I � ...... , <br /> .....__............::...............................i uaddle Complete <br /> .......................Lt............................I ........................................................................Pi pe <br /> .................._.................. ............... Service Cuck <br /> .._...._...................._.................... Scrvicc Box <br /> . No. Hours Labor..............................................Cost................................................... <br /> Cutin...................Pr.vemert...................X..............._....... ....................._.S9.Ft. <br /> ( � � ..X........................ ... ............. �� <br /> �l .................. ....... <br /> ' / c <br /> . � <br /> � , ..._..........._..R....................._' ......................_ u <br /> �y ....................X........................ ........................ „ <br /> �� — C ' � 0 Total ........................Sq.Ft. <br /> ___---_--__----r— -- -- - <br /> .i � <br /> Remarks..... .....�` ...'..lt...........:.:...:::..::._....._:..._........_....._................ .. <br /> � ' <br /> _.................................................................... ..._............................................... <br /> .. ......................................................................................................................... <br /> �'Jrder Recei��ed_..........................................................-fi:::....._,. :.,...,.,..�_.. <br /> .� n r !I 1� ✓..-"' , <br /> \�ork Completed....:1....'....:�.1........._�. ..:.............. . '� - . r� <br /> ... .......:..:.... .............. <br /> Foremzn <br />