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Pn1t­ ­w O. PORN <br />CITY OF EVERETT--Water Dept. <br />Application No.... Date...... ........ 1940/ <br />in,stall .......................... 2,; <br />.;.... inch water service pipe <br />For .......................... No................_................... <br />....... <br />......... Street <br />Lot...................................................... .... Block No ................ ....... ............ <br />Addition........................ . ...................................................................... *,**,*,, <br />Remarks....... ... ................... . .............................. .................... ........... ......... <br />Superintendent <br />LABOR AND MATERIAL USED <br />OrderReceived ........................................................ <br />WorkCompleted ..................................................... <br />