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*52 3 y <br />CITY OF EVERETT-•Water Dept. <br />.., <br />Application No.............1........... "Date ... ..... ..... Jllf1.1 ....... 19?.1........... 19...... <br />Install..._..........................inch water service pipe <br />For....1..../.....................�..) . - ........* ............/..�.J ........................... <br />. .. ... <br />On ................ Street <br />Lot.............................................................. Block No .............. ..... _.......... <br />Addition <br />Remarks <br />...... ....................................... --. --------------------------- --- <br />Superintendent <br />LABOR AND MATERIAL USED <br />........... <br />_...... ... .... ..........._.......... Lec:d Connection Complete <br />.._.........._.._.......................i Sadc']c Complete. _. .. ............. M._............ ..................... ..... ....................... ... ....... ......... pipe <br />.........._......:.................. Service Cock <br />......................_....... ............ I......... Ser.,Ice Box <br />... _.....................................—.....---------------------... _._ -. _.. <br />OrderReceived ............... ....... ...................................................................... <br />WorkCompleted......................................................................................... <br />Foreman <br />