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17(9024 1 Acct. No <br />CITY OF EVERETT--Water Dept. <br />Application No ............................. Date ..... &A!/ <br />Install- yV<L PtOl<e—inch water service pipe <br />Owner.. ..................... <br />Address ..... <br />Lot........................ . .................................. . Block No. <br />Contractor <br />Amt.................... . ................... Rec. <br />Superintendent <br />...... (P ............'.. <br />.MOL ...... <br />.w..J!9z�.eL? . . ...... ....................................... ............... ............... <br />........................................................................................... ...... . ..................... <br />Work <br />Completed.//- It ............ ..... .... ...... <br />Foreman <br />