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4. J. PFIfPC'7M �3�73 � � :- .. <br /> M'. I). 1'ORM � � <br /> CITY OF EVERETT-.•Water Dept. <br /> ., „ <br /> ,, <br /> Anplic�lionNr.`....r_.°.`�.. _.. Date_.._.....JUNt .. 1961 _19...... <br /> install........................_.....inch waler service pipe <br /> F�r .._....................... .. . . . _................ ........ ....................................... <br /> .. .... .... .. <br /> Or. .��"�.�.�..... . ..y��G:::�tr ... ..�<Cil��......._..... StreeL <br /> Lot........�............................................. ..... Block No..................................... <br /> ^ddition ._........... ..........._....._........................._...._...._....... <br /> ......................... <br /> Pcmarks .......................................................................................................... <br /> _...._._....__.. .._.... .............................................._.......................................... <br /> __................................_......_ ............................................_........ <br /> _................................................................................._............._............. <br /> _........._..................... ...................... ............ ..................__..................... <br /> Superinlendent <br /> I.ADOR AND MATERiAL USF.D <br /> ___ho__�_Sizc I _____ ___ <br /> ........ ..................�.....__....___...__I Lcad Cnnnection Complele — — <br /> .. . ....... .I.. __.� Snddlc Completc <br /> .... . <br /> ......_.......... ft.� . _..... .............. .... ...__._.___..._...... ..__....Pipc <br /> ....................__...................__.._.. Scroicc Cock <br /> ..........................._...................._... Scr�ice llox <br /> No. 2?ow�s Lahor._.........__....................._.......Cosl........................_.._....._.............. <br /> Cut i��............__...Pavement._.............._.X....................... ........................Sq.Ft. <br /> ....................X........................ �� <br /> ........................ <br /> _.._.............X................_...... �, <br /> . ...........__......... <br /> ...................X........................ �� <br /> ........................ <br /> Total ._...._...............Sq.Fl. <br /> ------ --- ------ <br /> ——_— <br /> P.emarks..... ...... ......................... _._......._.__...__.._...... ................................ <br /> ..........._........._............. __..._........................................ <br /> ........................................... . ................................................................ <br /> Grder Receiced_ _........... .. __ _ ..............._............._............... <br /> �SorF: Crm��letcd_ __.._.. . _._......__....__ _.__....._ � <br /> _... . . ......_.. <br /> Furemnn <br />