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� � <br /> � w.o.Fo.�> >uoo s�an ' <br /> CITY OF EVERETT•-•Water Dept. <br /> APPlication No._.....�.�I IO.... �te _...../.��.� _- ...19Z.� <br /> / <br /> Inst�ll 2 �_,.}_in�ch�wa�tcr�servicc pipe <br /> For....... .. _ �-4-4.. . ......... <br /> + <br /> On.._..._1..�� � _. ....� .. . ..._.... .. .__.... ..._........._.Stteet <br /> Loc_..... _............................___......._._BlockNo._._ _.._ ..._.. . ..._._............__.. _. <br /> Addition _ __._......._ ....:.._ _:. <br /> _._ . . _ ___.....___...................__......_.... <br /> Remarks .. ._.._.__._.... <br /> .._... . _ _ _ _ _._ _ ___... . ................ <br /> _.. __-- --_ __ _.. . ...._ _ ..._ ._...... <br /> __ _ _ _ _____ ___. _. ...._ .._. ... ..... .. ..._.... <br /> .....__._ . _........_.____._._..._ __ ..____.. ....___....._......_ ___..___- <br /> : .�.i�..�... �.��aryr' wn... vw�/ <br /> J�p� <br /> �- _ _ _---_--- ._ . ._ ... __"_—. '—_—_____"-_-.. <br /> LABOR AND MATERIAL USED <br /> -------- -- . .. _ __- ---- ----- — <br /> � No. ',__ _ Size ' <br /> . . . �._. _ .. _ __—__ _ ._ _. _. _ _ . <br /> . ,/ —__ . <br /> � .f . �:..'.X EqA Lend Conneccton Completc <br /> ._. .. ..._. <br /> �....._ � . ..... -3.!r� . . Saddle Cnompletc <br /> i_..... � . _ft. j; �. . __,� _1:1cWi�. ..._. ... _..Pipe <br /> ......... L....__.___..I.._j:.' . . Scrvice Cuck <br /> . _ .(.. `rtT�-d . Scrvitt Box <br /> _ ..... ... ......._. ...__ �..........__ .. ......__......._._. . ..._ ... ......._........._. <br /> —. . �. ..........___. '___..... ..�_... .._..._........__.. ... .... _. _. __... ....._....... .. ................ ._.................. <br /> _ 'I <br /> . ._. _. ..._.... ...._. .._ _.... .. . . ....... .. . ... . . . ... . ....._. <br /> No. Hours La6or � ._.:. _ ........0 �'7".6�_ --� �_. � <br /> . ... .......__ _ . ..... <br /> Grt in ___ .Pnvcmen�..._..__......_..X ._._ _ _... ...__......_...._S9. Ft. <br /> X " <br /> _.... .._.... . . ......_ .. . . __. <br /> � .� <br /> _ ._. . ..__.. .._...._._.....__.._ ._.....___ _.. <br /> X " <br /> . . . . ____ ._. _. <br /> Total . _ ._._.._....SQ. Ft. <br /> Rcmar.. y.,�..�n1 Slil� Nn.�_C 9/S __�•l. �J' <br /> L �! ��_ <br /> . ........... .� t-:l�"�d. T..�G<I�:GSI.lA.C� —t� .�'Gt-..t�£oit�-.E..a/ --. <br /> � � <br /> . ... ..... .. . . ._. .._..._. . . _. _... . ._ . ... <br /> Ordcr Rctcived <br /> �C/ork Complcred _ <..�� � �.��c, �..� �c�f <br /> Fonm � <br /> t <br />