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e. �. rnicoc xr�s�� � � y' ���� <br /> w.,o. ronM� 7 <br /> ..r <br /> CITY OF EVE.RETT--Water Dept. <br /> 4 �, � ` <br /> : ApPlication No......//.�//-- Date_.................1(.�.:5--.........19.::1.� <br /> 1 ` Insta l..f........inch water service pipe <br /> � � ------•-3 - � <br /> I � ' ' Sor <br /> �c..,/ <br /> ........._�.., . . <br /> .,E�:................................................._............... <br /> I � ���..:.:.. .. �e__ <br /> ` :. _ rr <br /> i ; . On ................. ....��..........�.�..2.,�..:: ...............---•-----....._..... Street <br /> i .. <br /> I - ` <br /> , .• Lot...................:.z_�..�--�..�....._.._... Block No.........✓.�2..�:f_-........--- <br /> . :. , <br /> Addition ...................:...................................................n........-----............... � <br /> r • <br /> �.tG, ,_ �.- <br /> Remarks ........�.'I/?:..:�...............?.;���4::............`�:.._..e!�i�y�,c_�/ <br /> I . � <br /> ........._.....::.........l.��J.....:G�.�`<::Z:L�..--- .l..l�....�Y!r?a;i.�•-Ct?;i <br /> ._...... . �L.�..cr�....................................................r'....----.............._........... <br /> � . ........ <br /> ' , , 1i'�.;� : <br /> �.. ......`................ � : .�t..{... ......................_..._........... <br /> . .:... <br /> � ..- -`--..._.. :.... <br /> �.'. . . ���3,) <br /> . . . rr � �� . � C l� <br /> � � ,,.._ .:�....:...j... ........... ..........."""'.................."' .. .....:�:...... .:?,::.:t <br /> �, -.� Superintendent ? <br /> ._ . ,_...�.- <br /> LABOR ANll MATERIAI. II3ED <br /> No. Size_� __ <br /> ...................................................... Lead Connection Complete <br />� .__............."'......................._........ Saddltt Complete <br />. a <br /> .............�.5�.ft._=.+�'. . . ..G'R.��l:�..................................................Pipe <br /> ..................I/........��/...'............. Scrvice Cotk <br /> ..................J........l..l:tt�Sr...... Ser•»ce Box <br /> No. Aours Labor..............................................Cost.................................................... <br />� Cut in....................PavemenL....................X......._............... ........................Sq.Ft. <br />� ....................}G...---...._.......---- ......._.._........... �� <br /> ....................X........................ ........................ �� <br /> ...................X....................... ........................ �� <br /> Total ........................Sq.Ft. <br /> ------ — <br /> Re�n a rlcs............................................................................................................. <br /> Grder Peceived.................�...............................:..........._i,oreman / <br /> \4ork Campleted..�/�.i:�. >. .�..............................:�f ! <br /> --. �. L:�Qz.cG.� � <br /> i <br /> � <br />