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� W.D.Form J 1(q1 11-10.N ' • . <br /> CITY OF EVERETT•••Water Dept. <br /> Applitatior No. .!�._�...1.�� atc. .. ___. I.��... 19Z......_� <br /> F '� <br /> r-� Install_ Y _ _ inch u�ater service pipc <br /> For _. _1-�..'?'�o'u-o�v�J _�" �'-.�^ <br /> �� �� _ _ <br /> pn I� o � ._..��--6--5 �C.� ... . _�trect <br /> Lot. ...... ..:. _ _Block No� _ <br /> Addition_....._...__._........................_ ......._.... ..............................___._ ..._.. .. ........... <br /> Remarks....................... _.._ ,............_....__....._......_.._ ... <br /> . ........_......_._..._i„.._....._......._.........................._............_..... <br /> ..... _. . ._..__.........__............. <br /> � .:.. .5.................._.._.......... <br /> ..... _........................_. __...._ __...... ............................_.._...... . <br /> ..._.............._ ._ __ .................._..._.... ...._._j._....... ......_ ._....�..�. _......_................. <br /> . . ...1/. �.... .�. . .... � .__...... <br /> ... . $Vpedntn_e aden .. <br /> _�_.___ _ _'—__ " ' _.. �v <br /> LABOR AND�MATERIAL ti5b:ll <br /> � --- - -`----- --- -- .___ . — . . . . . . ..- - <br /> No......... Size ' <br /> — ---- — -----. _.---- - . _ . _ . _ _ - - - <br /> —-- <br /> � ., <br /> ...........1.... . '._�<...'. Lced ConnecEion ComP�ete <br /> .........L........... i...'�j.A.a'..,;..� Snddle� CpomPlete <br /> ......._�......_.._ft.� ...:y _...._ _' ...�T.C[:S�.t-......................._........Pipc <br /> , � <br /> .........L................I__y..__...__. gercice Cock <br /> .....__!................ �e�Lt<,. . Service Box <br /> ...........................i .._..__........_ .�..... ......_.. ..............._........_.............................._.................................... <br /> ...........................i.. ._............._ __.........................................................._....................................__.. ... <br /> ' ....._.............__ ................... . ........._............_.................._ .. ..._..._..........__......_. . .. ..... . <br /> _ � "—'___ ..______�__.—'_—_'.___—_ <br /> ' ' No. Hours Labor..........Ly.........................Cost_33.4+`. . . <br /> . . ...._............................._. <br /> } ' Cut in........c._._........Pevement..... ............5.............._...__ .._..........._..Sry Ft. <br /> I� ........._......._5...._.................. ,� <br /> � .._............. . <br /> � - <br /> � ....................�_....._...._...._... .............___. ' <br /> I ....................%....................... .................... „ <br /> �' Total ............_......Sq. b't. <br /> � -_ . -_ -� —_-- <br /> . . "__-. _. .. -._— - .. _�� -_..— - �==- ---- <br /> Rem�rck�'�sy_Pd�a/t"..�sl �lip ly�n Z_b��€ .. .t• .,, <br /> . ¢?<4!`p.9`.A:l.iLJ[C....1,r.L. �4�'i.yvui� .. _..._.... ... ._.. <br /> _. / <br /> . .._. ....._. ._.. .. . . ... _ . __.Q� <br /> Ord t Riccived _. . . . . . .. . <br /> �C�url. Complctcd 4i � ��&���` <br /> Po¢mm 1 <br />