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a ,r. rninc aw �� � � � "_ V" l=,l ' <br /> w. o. ronw a <br /> CITY OF E.VERETT--Water Dept. <br /> Application :1c....l...l..✓.�. Date...f.-......._r-.��.. ....-•--•_------19r�:' <br /> i <br /> Install.......v................inch water service pipe <br /> For .........--�--��-/�..............................7............................................................�-�----�- <br /> On ..........�:�-•`•�.�................/..�� ... ��,.........--............... Street <br /> �-�- <br /> L,d....................................................._....:.. Block No........--------•------•--•--- <br /> !�dciition ...................�..............................................---......................... <br /> Remarks ................... . � . . . <br /> . .....--------.._............._�......---.........._.....--...... <br /> _...................................�' ;;"�.�...'"''`-L�r-�-- .. : --�-� /, / � <br /> ../..._. f.. . .. .. ---. . . .. � <br /> ................................_�.�..L�AS.:✓..'t.:�Yt.'.!F:.C..5:2.-.'._S:�r...---�(i_..`�._:L�r....�- <br /> ..... ...............�.....�............................. / .. <br /> . ..... <br /> .. , " f............................. <br /> . �.....w. . <br /> ����... ...>/� :... � .. :/m::'�•�-°- <br /> �:. .... .............................. ....�.. ...............-••----...... <br /> �v„�� �b / Superintendent <br /> LABOR AND MATERIAI, DSSD <br /> DIo. Size � � � <br /> ................._.... ...................... Lead Connection Cnmplete <br /> ..................................:................... Saddle Complete <br /> .......................St...................:....... ........................................................................Pipn <br /> ..................................................... Service Cock <br /> ...................................................... Service Box <br /> No. Hours Labor..............................................Cost.................................................... <br /> Cutin....................Pavemenl....................X......._............... ........................Sq.Ft. <br /> ....................X........................ �� <br /> ......._............... <br /> ....................X........................ �� <br /> ........................ <br /> ....................X........................ �� <br /> ........................ <br /> � otal ........................Sq.Ft. <br /> ---� — — <br /> -- . , — <br /> . . f : <br /> Remarks... ..........�:y:........�J.:...`.,..�......................................._................. <br /> / � <br /> ...................................:�.................................................:,..}.......f..�..f1.......... <br /> f ' i i ;�"'' <br /> .....- -............................._......................................�...._...:...� .,. <br /> , � �� ........................... <br /> Order Peceived........__................................. r�-• ' ' ....................__.... <br /> y _ r..V............... <br /> \Vork Completed�..:...': ,y `�. <br /> .......1.._�r............................................ ............... <br /> Foreman <br />