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Acct. No ... ............................. <br />CITY OF EVERETT—Water Dept. <br />Application No4) ... rkl ...... Date .............. ...... 191/ <br />Install_ ... 3_,'14................ inch water service pipe <br />Owner........................................... <br />Addre:s ..... �!.l <br />Lot.............................................................. Block No............... <br />Addition <br />Amt......................................... Rec. No................. <br />By........................................................................................ <br />Superintendent <br />ShopRemarks ........................................ ­­ ... ........... .......................................... <br />Work Completed._ .............. ..... . ............................. <br />