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, w. o_ronv a����� � . <br /> . . /V) - .� I1Y <br /> • ����c. no. ........._.................... <br /> CITY OF EVERETT—Wa:er Dept. <br /> Application No..._�;.:.�.`��.._... Date..--__._.__ �- <br /> '� ' _....._ ...... ._.... .'-.:.isG.�E. <br /> I " ry, <br /> InstalL.........��...._.......`.. inch water service pipe <br /> Owner.. ....._..-.�t, ,..t. <br /> � ................•-- <br /> y ............................... ............ .........._.....--.. <br /> Address._.(.c.�.:[__ �.... �r�....�ti:4� •i `�9ti,-c%.,.,L (t� <br /> �_._.._........... .................._.�`..-�................. <br /> �``---..... d <br /> Lot.._. .............._..._................................_...Block No...................._.......................... <br /> I Addition............................................................................................. ... ................... <br /> Contractor......................................................................................... _. <br /> .. ..................... <br /> Remarks........,�...................................................................................................... <br /> ......_��:.l,c..�.......................................................--.............................. <br /> Amt......................._......_........ Rec. No........................................_.._................----... <br /> I By........................................................................................ <br /> Superintendent <br /> "'"-..................----..........._............. ........................_................... <br /> ......................-•--........_-'-�---'--..........................._......_....._.__...---............._................... <br /> ......................._......_..................................................................._.................................. <br /> ....................'--'......._....................................................................................................... <br /> .................................�----.._.............................................................................................. <br /> -'.................................................................................................................---......._......... <br /> ..................................................................................................... <br /> Shop Remarks....................................... <br /> ..............................................................................................................._---................... <br /> ....--�--�..................................................................................................._...---................ <br /> ....................................................................................................................................... <br /> .......................................................................................... .......................................... <br /> \Vork Completed....... ...................................... . � <br /> _......................................._.... <br /> Foreman <br />