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w o. ronw�a I•�VV � ��'!•� ,� <br />CITY OF EVERETT--Water Dept. <br />A lication No.._::_' ` � � " <br />PP ,.:�..�� Date.......�:�.........�961 ...................19...... <br />,, <br />7nsta1l........_ .................... .inch water service pipe <br />,,.•.��:rs�;�� 1��;�L/�, <br />For .......:...:..:... �.........._........,.....::................:_:................................................. <br />�, r f" �J.r, � �.::' ........................................... Street <br />On ...........................:............................. <br />Lot................................�-- ........................ Block No..........................--�--...... <br />Ad�lition ....................................._................................................................... <br />, �l� ' <br />- <br />Remarks ....:,...:_�:�' .....:...........�.�:.t:..:::...'.:.,.......................................--- <br />..� f:,..... f.:.� ...............�....,...�.....,_..r.._...........................---............. <br />....�'..'.:r:....1...._f!..,.'........ �..-..t�...'�.�,2....,�` ............................................. <br />! <br />.................................................................-- ... - - - _ - _ _ <br />� Superintendent <br />� � <br />LABOR AND MATERIAL USED <br />No. i Size ( _ <br />.............I Lcad Connection Complete , ��; <br />�. -.. <br />............. Saddlc Completc , -� ' <br />��'...�:....`...'..: �. <br />............. .............................................:....... . ' .Pipe <br />............. Scrvice Cock <br />............. Seivice Hox <br />No. Hours Labor ...........................--...............Cost..._..._............................_............ <br />Cutin..._ ...............Pavement....................X...................__. ..............-----..Sq.Ft. <br />....................X........................ ,� <br />........................ <br />....................X........................ �� <br />........................ <br />....................X........................ �, <br />........................ <br />Total ........................Sq. Ft. <br />-- ---------�-- --- <br />Remarks........_ ............................................................................ - - .........._... <br />..............._...__................_....................... <br />........-- ... _ <br />Order?ieceiti�ed ............................................................................................... f <br />\Vork Complcted.__ ................. _.. _ ..........__ _ .._ __....... ...._......_. .. � <br />Foreman <br />