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4 7 J <br /> a e.�rniaec _/ I �� / � /���J � ✓ . <br /> w. o. ronr+ a � <br /> CITY OF rVERETT--Water L7ept. <br /> a c ��` f� �1 .� '!�AR 1 �962 <br /> Appl�ca4ion No. .. .... .: ... .. Date.......'............._......_..................19....- <br /> Install....__..._............_....inch w•ater service pipe <br /> /`� ��-/ � � <br /> b'or !�...:.��_�.�.........!� ^-�z.!L!L.,�J.!1.:1_L_.:L ./............... <br /> On .......:-1�.:�._�.�....-- y.1..�.. ...'�....�.�. -�C�:ti._................. Street <br /> Lot...._....._..................._............_.'........... Block No...................................-- <br /> P_d�3ition .................................................................. ........... ........................ <br /> Remarks ........._-............................................................................._ -......... <br /> __... .... .................-.... ..................- ...................................._-�---............ <br /> _........ ......................................................................................................�-----�•�- <br /> _...... _........................... ........ • --.....................................................------��-- <br /> Superintendent <br /> LABOR AND MATI RIAL USED <br /> No. Size I <br /> — — - ---- <br /> ..................................................... *ead Connecliun Complete <br /> ._........................................_......._ :addl� Comy`ete <br /> .......................ft............................ ....................................--�--................_..............Pip, <br /> ..........................................._...._.. Scrvice Cock <br /> ............................__........._.:........ Scrvice Bux <br /> ..................................................... ................................................................................................................ ,.: <br /> ✓ <br /> No. Hours Labor......._...._.._...........................Cost....................................._............. <br /> Cutin.....__...........Pavemcnt.._................X................_._... .........._.............Sq.Ft. <br /> ....................X........................ �� <br /> ........................ <br /> ....................X........................ �� <br /> .........._.........- <br /> ....................k........................ .� <br /> ........................ <br /> Total ........................Sq.Ft. <br /> _ __..__—_ -_.— <br /> Retnarks.............................................................................................. ........... <br /> _...............__....._... ........._.................................................................................. <br /> ............. ......................................_........................................_.................._..... <br /> OrderReceiced................. .....................................................:.......................` <br /> tVorkComplcted... ............._.... ..._...... _....... ..._._.....__......... ..._....... <br /> Foreman <br /> f <br />