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73 7tr <br />IORM 3 <br />Acct. N <br />CITY OF EVERETT—Watfr Dept. <br />7 Date ..... I ..... <br />Application No ... I .......................... <br />Install ... 7�/11 .. ........... inch water service pipe <br />Owner ......................... <br />.. ............................................... <br />Address ....... 01 C— S <br />...... ....................... ....................... . ... <br />"t ..... ....... ....................... ................ ....... Block <br />Addition <br />Contractor ... . .......... <br />y <br />( ............ C'-',) ..... <br />Amt ....... ......... ,ee. No ........................ <br />Superintendent <br />............. .. ........... . ................................................................................... .................. <br />....................... . ................. 6 .................. ............................................ <br />....................... . ............ 6 ................. ............................................... <br />Shop <br />Work CompIeted.../az..-.y..=..7/ ................. .. . ........ <br />Foreman <br />