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S.1.Pn.M{M7.1619tl:5� / ✓ ✓.� � <br />w. o. Pe.,� � <br />-' C'TY OF EVERETT--W <br />�� �c) <br />Application No ......................... D�te.. ........� <br />ter Dept. <br />�G, ,o `-� <br />water service'�ipe <br />" _ " �-�. `l; _. ...,;_ ... <br />For ..............L..... �..%... r.�.r.. :.. <br />.......................� ........._...... <br />� ��..r`:.......�/.:....s'..:'........:�:..:...c.t..�.... Street <br />On ............��� <br />.. . <br />Lot..................................... .:'�...".L-......... Block No......�� :�.................... <br />_ , .......................... <br />Addition /............................. �..�.... <br />Z,,r..�...... <br />..................... <br />,[.t::�:�..1..:�. �:/ �::;,..[.::....:.L. � .... <br />Remarks ..................... . <br />P <br />LABOR AND <br />Superintendent <br />-. i <br />................ <br />.................... Lead Connection Complete <br />Saddle Complete <br />...................................................... .........................................Pipe <br />....�J...Lt.. J....�.� .......... ..... . ., ..... <br />.................. . <br />....... ........ �V........ Servic ock <br />__..... Service Box <br />� <br />....li��iL ........................ . <br />No. Hours Labor ......................................... ........................59. Ft. <br />Cut /i ............`......Pavetnenl....................X..... ................. <br />�� / �C"' .............._...X.............:,........ ._....._..._........ �� <br />.................._X....................... . <br />�v X ..... ............ .....�_ ....� <br />...... <br />� /� ^*� �^.� ..Sq. Ft. <br />Total ...................... <br />F — <br />Remarks. <br />�.er:� :�.�'� <br />....................-� i. <br />............. _..... ,. r <br />�.. ^ �� ,. . _ � ...... <br />n� C.. ��'1� � n ..:: !�.......:f'..� . ......i. �.� 4 .............. <br />, .�y,i,, . ..... ........ <br />.................. ..... _....... �f` � <br />Order Received....:..� .............../............................. � .....,-........................ ; <br />... . . / <br />\Vork Com leted...l.b�?.`[�l..L!.' ............. � :'I rl6.l�!.Y.L:....... � <br />p f ..,..,.� ......... <br />, Foreman <br />