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CITY OF 'E/VERETT-•Waa r Dept. <br />Application No.zr3!4-. Dat ._. !_4 %_.!�-IS ...... 19�% <br />In Il.. _. _ _ inch water service pipe <br />t <br />For ----•--------- -- <br />7'L!L' tL. <br />On ........ .. �` Street <br />Lot f� : Blocckt No. <br />Addition .. �'! 4!! _i»'Y'!. } !/ /I -.. <br />Remarks ---- :..... G7tFa't.t?- <br />`-...... .. ♦ L. <br />LABOR AND MATERIAL USED <br />__.....----- <br />*________________ Lead Connection Complete <br />..... Saddle,Famplele <br />�. Y <br />-"'-'-4=.... rt ---- /-------- -------el.-.-a.=-=rc. �.. .............. -.... Pipe <br />_______________ _______________ Service Cock <br />.--.-_.------- _______________ Service box <br />No. Hours Labor .............. ...... ..._._............ <br />Cut in ............ Pavement.- ---------- X ............. .......... _.. Sq. Fr. <br />.. X. .... ......... <br />r V „ <br />Total ----- I ......... Sq. Ft. <br />Remarks------------------------ — ---------------------- <br />Order Received ------------------ -------- <br />\Work Completed _____________________________________________ <br />Foreman <br />