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7 - � <br /> s.r.P�o�..b��bz9�v v , <br /> w.o.ea�� M <br /> CITY C�F EVERETT--Water Dept. <br /> , � - - <br /> �: ��� %; . . -� , , ; <br /> Application No........_:.............. �Date..................� `' ...19.....� <br /> . ........ <br /> .......... <br /> �/ „ . <br /> I i " � Inst 11.. _`:...`�................icich water service pipe <br /> � , „ <br /> � �?, � �- . � , , .. <br /> = Foc ..............�.......: ...,.. ... ., ...----.......::.................................................. <br /> � � �, ,. � X ' on :, /, ' � <br /> .. 'T' t� ..........._�......................../.1...........::.....k........'..::_:......... ...... Street <br /> .- ,, . <br /> . <br /> - <br /> omii ?� t:>................�.........^..'..................----...... Block No...........:.^.�:-.............. <br /> „r.- � ddi'ion ...... n......_................. ............................................. .. .... <br /> .. . ... .... . <br /> • ;; . _ . / <br /> � <br /> �' �e�r� < r' , • ...... _ <br /> L� .......... � . ., a � -�( �..0.......'��-4 ,� , <br /> , � <br /> � :�.....�....................................�..................� �.. ' <br /> ��>a G �' / <br /> ✓ ✓ <br /> ��.. . ....... . . .R�..... .�f.........................:..................................... <br /> �......... <br /> J ��............... �/�� �i; ., r,. c_ <br /> -�'.................�-............... :......... ............._....1..�......................................................_ <br /> U <br /> ' �j U......_........................... .............................................................'-'---........._.....,.. <br /> �....�......r-, . : � ; <br /> .................................................. ................................. ...._.......... <br /> rintendent <br /> . -� <br /> � ' '/. <br /> o: ; � , rc � <br /> � LABOIi AND MATERIAL USBD j', <br /> No. Size I <br /> — --- <br /> ......................................................I Lead Cor.nection Complete <br /> ...................................................... Saddle ComPlete <br /> .....................St............................ ........................................................................Pipe <br /> ...................................................... S=rvice Cock <br /> ...................................................... Servicc Box <br /> No. Hours Labor.............................................Cost..........................._....................... <br /> Cutin....................Pavement....................X........................ ........................Sq.Ft. <br /> ....................X........................ „ <br /> ........................ <br /> ....................X........._.............. �� <br /> ........................ <br /> ....................X........................ �� <br /> ........................ <br /> Total ........................Sq.Ft. <br /> ----- — <br /> ftemarks,.f .�' r `{l�' ` <br /> • .............................................................................. <br /> ,.. ._....... ..,:j <br /> ............. ......................................................................................................... <br /> ................ .............................................................................................. <br /> OrderReceived....................._..............................�..f......�........ �..............._ <br /> i .� . i ', ..t 1 <br /> R'ork Completed.t ri'.::._�:...................�....:c..:.`..rl....r..' .........._ � <br /> / r�eman <br /> � <br />