Laserfiche WebLink
VJ��D Furm,J17-I639.�n /,J � 3 <br /> CITY OF EVERETT--Water Dept. <br /> � .� . ; , - � <br /> � .. , , <br /> Application No...:........._..:....... Date;......__..........�................:.........19'_.... <br /> Install..........'..����- --����ch water service pipe <br /> - --• <br /> .....................:._.................... .. <br /> For ._..............................................__.,..�. , �C=r � .s.. Street <br /> � ��—; � � .� <br /> _,_, �,..�....:...................... <br /> On ......................... <br /> .......................::...............�. <br /> Lot.............................................................. Block No..................................... <br /> Addition ����� <br /> ..................................................................................................... <br /> Remarks ................................................................................. <br /> .........................�. <br /> _................'....._....... , . <br /> � .. � , ; -, .� . <br /> ....................... <br /> .,� ....__................�............... <br /> ............. ....��....................._....... , . <br /> ................._.:.1....._.. t� , � , . {., , <br /> � , � . ; , . ._ -.,.. <br /> � . <br /> . „ ......�"_"'_"...... � <br /> .... <br /> � ��............:.............:..........................................SuPerintendent ' <br /> ............................ , . <br /> LABOR AND MATER[AL IIBED <br /> _ na, Size , — <br /> -.— _— <br /> ._.__.——_— <br /> I Lead Connection Complele <br /> .....................................................I <br /> _ Seiddle Complele <br /> ..................................................... ...........................Yi e <br /> ' .......................ft...........................1 ............................................ P <br /> _ ........... ... Servicc Cock <br /> ......................... <br /> _.._ . <br /> .......................___.................._..._I Scrvicc Box <br /> .�........�_.�_..... �......_..�..._�.._...I .........._........_.�..._..�....._.�_........_.._�.._.._..._.._.�_.._.............__..........._.. <br /> ._._......... <br /> No. Hovrs La or._.._....................................... <br /> . ............. <br /> ...........................5...-Ft. <br /> Culin.__..__..__..Paecment........_........_X..._.._............... ........................ q. <br /> ....................X........................ ........................ <br /> �, <br /> ...................Y........................ ........................ <br /> „ <br /> ....................X........................ <br /> ........................ �� <br /> Total ........................Sq.Ft. <br /> `__—..- -. ___ . . <br /> . . � i : . �., . <br /> .. . ...__...........................__........... <br /> '..i.......:._...:........... <br /> Rcmarks_....:..;'._......._..... , ; <br /> . , r <br /> ..__....................�. ..:.......::_:......c:.............................._......._____.----................ <br /> _._.._._..__...._.__..._................................................. <br /> OrderReceived._...._............_.._............................._........:.......................... <br /> \Cm•k Cor,�pletcd..._.--....:.:.:�_::...:...................................-........_Foreman... <br />