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i <br /> vl'o. roaw � 2 �I O � • ' "1 (,' �� a <br /> n. d. re¢ec <br /> CITY OF EVERETT--Water Dept. <br /> ;- ,. .� <br /> . - . :� �,� , , ,. . . ; <br /> Application No...�...:,.:..:.�....: Date.�._�`::_......:::: '� � <br /> : . ; • <br /> ....................19...... <br /> i� Tnstall.....:�,tt.`�..:............inch water service pipe <br /> L ; , <br /> For.............�� . , > - � <br /> C� . � n �. <br /> ..............�....y..�__......r, - �� - .c..e...�............................... ...............---�- <br /> �:"'.Ff'..?<� " ' ��.e�J... Street <br /> ,........... <br /> On ... .. �,.......:..:J..::..:.....:..:..:.: <br /> / ................. .. <br /> Lot...............:...-/•-........................:........... Block No..................................... <br /> Addi[ion <br /> ...............................................................................................�---....... <br /> Remarks ................................................. <br /> ......................................................... <br /> �-�..�..`.:.. ............ .......................---.............. . <br /> __ <br /> ... . <br /> , <br /> �.....�..... a........../�:........................�..........-..-.__�..:- '---...---....... <br /> ....................... <br /> , �r(.c.- �{/ � <br /> ......... .....................................:...................... � ..........,....: . ....... <br /> `-- , ,. �. i <br /> . ................................................................ . <br /> , ri �'-•�.._�:-..;.: ....,�......-- <br /> � � Supermtendent <br /> � <br /> _ ,� � <br /> =� <br /> GABOR AND MATERIAL UgED <br /> No. Size <br /> .. . ............................................ :.cad Connection Complete <br /> ...................................................... Saddle Complete <br /> .................I....ft...._i /ti.............. ...i...r..:�_:.:.�.:_...............................................Pipe <br /> .......................�.........?./..'<............. SerWice Cock <br /> .........................1..................,......... Service Sox <br /> .................._............................. ............................................................................................................... <br /> ..........................I.......................... ............................................................................................ <br /> t7o. Aours Labor..........................._.................Cost...............:.................................... <br /> Cutin....................Pavemenl....................X........................ .......................Sq.Ft. <br /> ,, <br /> � -. �� �� .. � .................._X........................ ......................_ �� <br /> )'� , <br /> ....................A........................ �� <br /> ........................ <br /> ....................R........................ �� <br /> ........................ <br /> '-- <br /> Total ........................Sq.Ft. <br /> '��==z----- -- <br /> Remarks................_ —r--- <br /> r <br /> i 1,..� <br /> ...........................--...._............................_..................... <br /> ... ................ ........ .............. . ..... ................................ <br /> _. ' <br /> OrderReceived.....................................................r......... .............................. <br /> � . ,� , <br /> lVork Completed....`...........:........'_.....................:..:. <br /> ........................ ............. <br /> Foreman <br />