321 ROSE WAY 2016-01-01 MF Import

� - /7/��- - � �� -.�-,�. � �; w. o. rosw a . CITY OF EVERETT--Water Dept. Application No..�.%.1.��.y. - Date...........:�....�....�_� .............19.... 7n;;ta11 .............................. .inch water service pipe For..............._..................., � 3.� � �� i��a_�....�`'-t�� ............................................. On....................................................................�................................. Streel Lot.............................................................. Block No..................................... Ar.idition .......................................................................................................... Remarks.......................................................................................................... No. i Size LABOR AND MATERie1L Lead Connection Complete Saddle Complete ...................... .... . ....................... ........................ Servicc Cock ......................... Scr�ice Box ........................... ... ..................... ...........................� ......................... ................................ P i p e No. Hours Labur ..............................................Cost.................................................... Cutin ....................Pavemcnl....................X........................ ........................Sq. Ft. ....................X........................ �� ........................ . ., ................... ........................ ........................ ....................X........................ �� ........................ Total ........................Sq. Ft. — ----- - - -- — --- Re m a r ks ............................................................................................................. Order Received ............................ \tiork Completed._ ..................._ .. ............... .............._........... _.�.... _..........__ __.. ._.._ ................'... Forem�n