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♦\/. FO� �� <br />Acct. No ................................. <br />CITY OF EVERE7T—Water Dept. <br />Application No%.... �i�/�P.._..... Date........._.-./ .- `� ...................19...�.: � <br />Install......���.y.....�..,..�....... inch watcr service pipe <br />Owner........ �..'/ .... ......................................................................................... <br />Address......... �....�l.'.�'...%�...... � �z- ..T...��2 ....... ............................................ <br />Lot.. _...........>� .. .............................._..... Block No............................................... <br />Addi tion ....................................................................................................................... <br />Contractor ................................................................................................................... <br />Remarks...................................._..................... - - .....-- -- � �-- --- ---- <br />Rec. <br />By................................................................................ ....... <br />Superintendent <br />Shop <br />........................... ............................................................._. .......... .. . ........... � <br />1 �/ / <br />Work Completed...�..-/�'.::%�.........�'���:,G�%7G.`�^,fC..... <br />Foreman / <br />