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W. O. fOqM J � � �"'� �� <br />. � � �. -. ,.. <br />n��t. n�. ...:.�-. _-_ _ _._ _ <br />�ITY OF EVERCTT—Watrr Dept. <br />Application No., ./..fp,.:r..1/_. Date...__.._..__....:�_tl ...............19.-C-_� <br />Inslall .................._............ inch water scrvice pipc <br />Owner..........--._ ................._.............. .............................._ ............................._..... <br />Address........_.�..�,��... �L�_.,ca�n�::.a.�-rx,,,>._��c-_�_. <br />................... <br />Lot.........._..._.....--..._........-- ................ Block No.............--...._............ -........... <br />Addition............_ ......................_............... .....--�� .._...__.............._............. <br />Contractor............................................................................................................. <br />Remarks .............: ��:'.�c-............... ...... <br />�'..:'...... - ......._ ..................................... <br />A�nt....... .... <br />Rec. No ........................................... <br />IIy..... <br />Shop Remark� ................................... <br />.......... ._._... .. <br />Superintendent <br />N'ork Completed .... ............................__..__......_...._._._ ._................ <br />Foreman <br />